L3 Metastatic Tumor from Adenocarcinoma of Prostate
Published by Dr. Mayur Kardile — Pune Spine Institute
Case Overview
A 65-year-old gentleman on treatment for adenocarcinoma of the prostate complained of back pain and shooting sensation in both lower limbs and perineal area.
MRI revealed a tumor in the L3 vertebra pressing on the Cauda Equina (lumbar nerve roots). CT scan showed complete destruction of the L3 vertebra.
Surgery was performed in two stages: 1. L3 Corpectomy (removal of the tumor-affected vertebra) and reconstruction through a lateral retroperitoneal approach through the flank 2. Posterior percutaneous pedicle screw instrumentation with cement-augmented screws
The patient underwent radiotherapy and chemotherapy 10 days after the surgery.
The retroperitoneal approach does not involve any muscle trauma, hence wound healing is better — which is crucial for patients undergoing post-operative radiation therapy. Cement-augmented screws provide better purchase in osteoporotic bone common in cancer patients.
Key Case Highlights
- 165-year-old with prostate adenocarcinoma metastatic to L3 vertebra
- 2Symptoms: back pain + shooting sensation in lower limbs and perineum
- 3CT: complete L3 vertebral destruction
- 4Two-stage surgery: lateral L3 corpectomy + percutaneous cement-augmented pedicle screws
- 5Retroperitoneal approach: no muscle damage → better wound healing for post-op radiation
- 6Radiotherapy + chemotherapy started 10 days after surgery
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Dr. Mayur Kardile
MS Orth | DNB | MCh (Toronto) | FRCSC
Fellowship-trained spine surgeon from Toronto. Trained in North America with expertise in complex deformity correction, minimally invasive surgery, and revision spine procedures.
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