Metastatic Disease to the Pedicle

A 68 year-old man presented with a six week history of low-back pain followed by shooting pain down the right leg.

Outline the Tumor                                             Note the Normal Left Intervertebral Foramen

Metastasis to the Pedicle: Axial MRI scans at the L5 vertebral level; (Left) T1-weighted scan; (Right) T2-weighted scan. Note the large tumor arising from the pedicle on the right, obliterating the neural foramen at that level.

Metastatic tumors that affect the spine often begin as a metastasis to bone, especially the pedicle. As they grow, they cause local pain. They then enlarge further and affect the exiting nerve root at that level resulting in a clinical radiculopathy. Only later do they grow and compress the spinal cord or cauda equina, depending on their location.

Revised 11/29/06
Copyrighted 2006. David C Preston