Single-Position Synchronal Management of Metastatic Prostate Cancer of the Spine and Femur Using Prone Nailing

Abstract

Case: A 71-year-old man with castration-resistant Stage IVB prostate cancer developed symptomatic oligometastatic disease in the lumbar spine and bilateral proximal femurs. He was treated with a single-position L2-L4 kyphoplasty with concomitant prone left-sided femoral prophylactic cephalomedullary nailing. Six months later when he again lost the ability to ambulate, he was treated with a single-position L4-L5 laminectomy for an epidural tumor with prone right-sided femoral prophylactic cephalomedullary nailing. Conclusion: Single-position prone surgery of the spine and prone femoral nailing is feasible and improves on traditional multiposition approaches, eliminating the need to reposition or change tables during management.