PMC3707324_01
Preoperative T1-weighted (a) sagittal and (b) axial and T2-weighted (c) sagittal and (d) axial MRI reveal enhancing epidural tissue along the posterior aspect of the L4 vertebral body with extension into the L4-L5 foramina bilaterally
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F1
Magnetic resonance imaging (MRI) confirmed an enlarging epidural tumor extending from the L2-L4 levels, involving the L4-L5 level, and extending into the L3-L4 and L5-S1 right neural foramina [Figure 1].
Intraoperative fluoroscopy utilizing MIS retractor (a) K-wire targeting involved disc level (b) Serial dilators were docked onto the facet complex (c) A tubular dilator was used, which was angled rostral (d) and caudal (e) to access the extent of tumor
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F2
Postoperative T1-weighted (a) sagittal and (b) axial and T2-weighted (c) sagittal and (d) axial MRI reveal interval L4 level tumor resection and decompression of the nerve roots
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F3
Postoperative MRI demonstrated adequate decompression of L5 nerve root [Figure 3].
PMC3707324_02
Preoperative (a) sagittal and (b) axial T1 and (c) sagittal and (d) axial T2 MRIs reveal diffuse lumbar metastatic disease, L1 vertebral expansivity causing near complete canal occlusion, and left-sided L1 and L2 foraminal impingement from an epidural mass
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F4
Imaging of his lumbar spine demonstrated L1-L2 vertebral body metastasis with bilateral L2 foraminal compression [Figure 4].
Postoperative T1-weighted (a) sagittal and (b) axial and T2-weighted (c) sagittal and (d) axial MRI reveal interval surgery at L1-L2 resulting in decompression of the spinal canal
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F5
Postoperative imaging demonstrated decompression of involved area [Figure 5].
PMC3707324_03