Intramedullary Spinal Cord Metastasis Treated with Prophylactic Laminoplasty Prior to Radiation to the Spinal Cord: a Case Report

Background:A cervical laminoplasty is a surgical procedure used to treat moderate-to-severe cervical stenosis resulting in cervical myelopathy. It is performed to widen the spinal canal and reduce compression on the spinal cord and surrounding nerves. Though often performed electively on patients presenting with varying degrees of neurologic dysfunction including weakness and imbalance, it may also be used prophylactically when spinal cord inflammation or edema is anticipated. Radiotherapy in the spinal cord is known to produce radiation-induced damage leading to radiation myelopathy.Case Description:We present the case of a 62-year-old male diagnosed with both cervical stenosis and an intramedullary cervical spinal cord metastatic tumor. This patient presented with significant symptoms including limited mobility, numbness, lower back pain, paresthesia, and spasms in both legs as well as worsening sexual function. Given that the patient was to undergo radiotherapy, a cervical laminoplasty was performed to eliminate ongoing spinal cord compression as well to prevent future neurologic decline resulting from post-radiation inflammation and edema.Conclusions:This case highlights that cervical laminoplasty can be performed safely and effectively with significant improvement in patients with metastatic disease. By treating the underlying symptomatic stenosis, and protect the patient from the potential for spinal cord edema from radiation to a spinal cord lesion in an already narrow spinal canal.