Total En Bloc Spondylectomy for Thoracic (T8) Spinal Metastasis of Renal Cell Carcinoma – A Case Report and Review of Literature

Introduction: Renal cell carcinoma (RCC) is notorious malignancy that could metastasize to lungs, lymph nodes, bones, and other internal organs. The spine is the most common area among bones where it metastasizes. Two main concerns for the spine surgeon regarding spinal metastasis are the stability of the spine and the prognosis of the disease. Total en bloc spondylectomy (TES) is a well-known procedure employed for the excision of metastatic lesion to the spine. Case Report: We report a case of 61-year-old elderly male with RCC with a past history of pulmonary metastasis, who presented to our institute with complaints of back pain and limited mobility in 2024. Radiological evaluation detected the lesion of the T8 vertebra. The patient underwent comprehensive evaluation with validated scoring systems (Modified Tokuhashi score of 10, and Spinal Instability Neoplastic Score of 14). Pre-operative embolization and then TES of the T8 vertebra was performed. There were no perioperative complications and he was able to mobilize post-operatively with some improvement in his neurological status. Conclusion: This case demonstrates the step-by-step approach of TES for the malignant spread of RCC to T8 vertebra with rewarding perioperative results. Keywords: Metastasis, spine, renal cell carcinoma, spondylectomy, total en bloc spondylectomy.