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F/48

C.C> #1. LBP with Rad. Pain to both L/E (20DA onset, 10DA aggravation)
#2. RUQ discomfort (2MA)

BHx> #1. known PLCa Pt. (7WA 진단)
#2. 20DA LBP with RP to both L/E developed : 걷기 어려울 정도
(previous LBP Hx(-) )
Radiating pain : anterolateral aspect of both L/E
both L/E Numbness(+)
#3. 10 DA Sx aggravation
voiding difficulty + (abdominal strain ↑)
defecation : OK

P/E>
SLR 70/70 Patrick -/-
Motor : Hip flexor, quad, hamstring, TA, EPH, FHL : 5/5
Sensory : L3 area numbness and tingling sense (+)
Circulation : physiologic
K/J ++/++ A/J ++/++ Babinski -/- A/C -/-
Paravertebral tenderness (+) on L3-4 level

MRI : Two bone metastasis, L3 and sacrum

Bone scan : 1. Mildly active bone lesion left 9th rib.
2. Photon defect in L3.

Imp> PLCa meta, L3 and sacrum

Op>
#1. Posterior stabilization, L1,2-L4,5
#2. Ant. decompression with Rt retroperitoneal approach, L3
& bone cement filling with pins