Presented by: Dr Maree Colosimo – Oncologist Dr Paul Licina – Spine Surgeon Event: Challenges in the Ageing Spine - 2014

1. Spinal
metastases
Dr Paul Licina – Spine surgeon
Dr Maree Colosimo – Oncologist

2. 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

6. • 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

8. Presentation
• Malaise, anorexia, weight loss
• Severe back and leg pain esp at night despite narcotic
analgesia
• Difficulty mobilising
• Perineal numbness
• Difficulty passing urine

9. Examination
• Pale and unwell
• Incapacitating pain at rest
• Only walking a few steps unaided
• No significant lower limb neurological deficit

12. Discussion

13. Treatment
• Urgent review by oncologist
• Surgical stabilisation

15. Histology result
Radiotherapy
Chemotherapy

16. Discussion

17. Thank you