case_images: PMC3707324_01
case_images: 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
case_images: SNI-4-78-g002.jpg
case_images: PMC3707324_01_SNI-4-78-g002.jpg
case_images: F1
case_images: 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].
case_images: 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
case_images: SNI-4-78-g003.jpg
case_images: PMC3707324_01_SNI-4-78-g003.jpg
case_images: F2
case_images: 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
case_images: SNI-4-78-g005.jpg
case_images: PMC3707324_01_SNI-4-78-g005.jpg
case_images: F3
case_images: Postoperative MRI demonstrated adequate decompression of L5 nerve root [Figure 3].
case_images: PMC3707324_02
case_images: 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
case_images: SNI-4-78-g006.jpg
case_images: PMC3707324_02_SNI-4-78-g006.jpg
case_images: F4
case_images: Imaging of his lumbar spine demonstrated L1-L2 vertebral body metastasis with bilateral L2 foraminal compression [Figure 4].
case_images: 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
case_images: SNI-4-78-g007.jpg
case_images: PMC3707324_02_SNI-4-78-g007.jpg
case_images: F5
case_images: Postoperative imaging demonstrated decompression of involved area [Figure 5].
case_images: PMC3707324_03