Metastatic Prostate Carcinoma to the Spine with Kyphoplasty Cement Augmentation

1. UCMC Spine Conference
Metastatic Disease to the Spine
June 6th, 2014

2. (from Greek
προστάτης,
prostates,
literally "one who
stands before",
"protector",
"guardian"

4. One in seven lifetime risk USA

5. 1 out of 35 men die from prostate
cancer

10. PSA

12. 11/21/12
80 year
old man
with fall
and LBP R
sciatica

14. 11/22/12

15. 11/23/12

18. Video

19. 11/29/12 L4 kyphoplasty for fracture with R L2L5 decompression

22. 12/28/12

23. 12/28/12

24. 12/28/12

28. 3/5/14 Dx prostate cancer

29. 3/6/14

31. Readmitted through the ER 2
months later on 5/10/14 due to
inability to ambulate from
intractable LBP
Not able to care for himself at
home.

32. Bone scan 5/13/14 stage 4 prostate ca; frontal skull, ribs L1, R6,R7, Prox R femur, L iliac, L1?

34. Skeletal met of unknown origin
• 40 patients prospective
• CT chest/abd/pelvis 75%
• H&P: 8%
• CXR: 43%
• CT chest 15%
• Ct Abd 13%
• f/u CT 5%
• Tissue: 8%
• 85% chance of finding Dx preop with studies
• LABS: SPEP
• Avoid primary sarcoma, better biopsy area, renal cell

37. Spine Conference
6/6/14
Pathology
A. E. Seiguer, M.D.

38. W.H.
S14-3034, 5/22/14
L1 fracture biopsy

45. PSA

46. PSA

50. Most Common Mets
to Bone
• Breast
• Prostate
• Lung
• Renal
• Hematopoietic tumors
• Thyroid

52. 86 YEAR
OLD
WOMAN
LBP FALL

54. HETEROGENEOUS

56. THANKS!!