Fig. 2.

A case of metastatic spine disease from hepatocellular carcinoma. A : A 61-year-old male with hepatocellular carcinoma presented with progressive L2 metastatic lesions even after radiotherapy. B : Arteriography during preoperative embolization showed the presence of Adamkiewicz artery arising from the left side of L2 segmental artery. Arrowheads indicate the characteristic hairpin turn of the Adamkiewicz artery. C : Palliative surgery (L2 corpectomy, L1–3 anterior interbody graft with posterior instrumentation and posterolateral fusion) was performed. D : However, loss of motor evoked potential in intraoperative neuromonitoring was noted during the excision of tumor and L2 vertebral body.