Circumdural decompression by posterior vertebrectomy for relief of cord compression due to metastatic disease of thoracic and lumbar spine.

Circumdural cord decompression with total or almost total vertebrectomy in the thoracic or lumbar spine through a posterior approach can provide optimal decompression of neural tissue. This procedure combined with posterior instrumentation and immediate reconstruction of the anterior defect with polymethylmethacrylate can provide adequate stabilization. Immediate ambulation with minimal external support is possible. This single operative approach is preferred to anterior (transthoracic or retroperitoneal) decompression due to high morbidity associated with the latter. The authors' experience with this procedure in four cases is presented.