Figure 4.

Imaging studies from a 65 year-old man with renal cell carcinoma metastatic to T10 resulting in Grade 3 epidural spinal cord compression and myelopathy (A). T10 laminectomy, bilateral T9–T10 and T10–T11 facetectomies, transpedicular resection of ventral epidural tumor, and T8–T12 posterolateral instrumentation and fusion were performed (B). Postoperative myelogram shows complete circumferential decompression of the spinal cord (C). Postoperatively the patient received 2850 cGy in three fractions.