FIGURE 1.

Case example: 50-yr-old male with history of widely metastatic adenocarcinoma of the lung. He presented with severe, debilitating mechanical back pain. Neurologically intact at presentation. Imaging demonstrated multilevel spinal metastases, particularly a progressive lytic compression fracture at T7 with bilateral posterior element involvement (spinal instability neoplastic score 13). There was no apparent spinal cord compression. Notably there was an old planum burst fracture at T5 and sclerotic lesion at T4 providing a rigid junctional level above the planned construct and hence he underwent T6-T8 percutaneous stabilization with T7 kyphoplasty to ensure anterior column support. There were no postoperative complications and the patient was discharged home 3 d after surgery with significant improvement of his back pain at follow-up. A, magnetic resonance imaging T1 noncontrast enhanced demonstrating the hypointense T7 lesion with compression fracture and posterior element involvement. B, Postoperative computed tomography scan demonstrating the PMMA filled vertebral bodies along with the sclerotic and mixed lytic-sclerotic multilevel tumor infiltration. C, Postoperative sagittal and D Anterior-posterior x-rays demonstrating the stabilizing construct.