# Total En Bloc Spondylectomy in a Case of Solitary Metastatic Breast Carcinoma With Intact Neurology: A Case Report

## TL;DR

A 48-year-old woman with metastatic breast cancer underwent a complex spinal surgery to remove a vertebra while preserving her neurological function.

## Contribution

This case report highlights the successful use of a combined surgical approach for total en bloc spondylectomy in a neurologically intact patient.

## Key findings

- A combined surgical approach allowed safe removal of the D8 vertebra in a patient with intact neurology.
- Posterior approaches alone carry a high risk of postoperative neurological deficits in such cases.
- The procedure was effective for managing solitary metastasis from breast cancer.

## Abstract

The management of spinal metastasis varies from patient to patient, depending on the type of lesion, stage of the disease, extension into the spinal canal, associated fractures, and life expectancy. We present a case of solitary metastasis with intact neurology in a 48-year-old lady who underwent a radical mastectomy for T2 N3 M0 breast carcinoma 34 months ago. Total en bloc spondylectomy in a neurologically intact patient is a challenging one. In all posterior approaches, there is a high chance of postoperative neurodeficiency. In our case, a combined approach seems to be a much safer procedure with easy accessibility to remove the total D8 vertebra.