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