Spinal metastases
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Transcript of Spinal metastases
Spinal metastases
Dr Paul Licina – Spine surgeon
Dr Maree Colosimo – Oncologist
Case presentation
History
• 61 yo teacher
• Previously fit and active
• Excellent medical health
• Developed severe left mid-back pain radiating to
abdomen
• Saw GP after 4 weeks
• Commenced Endone
• Went on cruise
• Developed worsening back pain and bilateral leg pain
• Returned home early
• Developed difficulty with bowel and bladder control
• Seen at Caboolture Hospital – analgesia and
physiotherapy
Presentation
• Malaise, anorexia, weight loss
• Severe back and leg pain esp at night despite narcotic
analgesia
• Difficulty mobilising
• Perineal numbness
• Difficulty passing urine
Examination
• Pale and unwell
• Incapacitating pain at rest
• Only walking a few steps unaided
• No significant lower limb neurological deficit
Discussion
Treatment
• Urgent review by oncologist
• Surgical stabilisation
Histology result Radiotherapy Chemotherapy
Discussion
Thank you