FIGURE 1. Axial T2 (A, B) and T1 postgadolinium (D, E) spinal magnetic resonance imaging demonstrating a contrast-enhancing mass at T4 and T5 with significant.

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FIGURE 1. Axial T2 (A, B) and T1 postgadolinium (D, E) spinal magnetic resonance imaging demonstrating a contrast-enhancing mass at T4 and T5 with significant epidural compression deforming the spinal cord. Sagittal T2 (C) and T1 postgadolinium (F) images also demonstrating the mass as well as greater than 50% loss of height at T5. This mass was confirmed as metastatic adenocarcinoma. From: Minimally Invasive Circumferential Spinal Decompression and Stabilization for Symptomatic Metastatic Spine Tumor: Technical Case Report Neurosurgery. 2010;66(3):E620-E622. doi:10.1227/01.NEU.0000365270.23815.B1 Neurosurgery | Copyright © 2010 by the Congress of Neurological Surgeons

FIGURE 2. Axial (A, B), sagittal (C), and coronal (D) computed tomography of the spine with lytic destruction of T4 and T5 vertebral bodies with greater than 50% loss of height at T5. From: Minimally Invasive Circumferential Spinal Decompression and Stabilization for Symptomatic Metastatic Spine Tumor: Technical Case Report Neurosurgery. 2010;66(3):E620-E622. doi:10.1227/01.NEU.0000365270.23815.B1 Neurosurgery | Copyright © 2010 by the Congress of Neurological Surgeons

FIGURE 3. Intraoperative fluoroscopy demonstrating percutaneous placement of T1–T3 and T6–T8 pedicle screws using Depuy Viper II system (A–C). Placement of transmuscular dilators (D), expandable tubular minimal access retractors (Pipeline, Depuy Spine) (E), and expandable cage (Globus Medical, Audubon, Pennsylvania) (F). From: Minimally Invasive Circumferential Spinal Decompression and Stabilization for Symptomatic Metastatic Spine Tumor: Technical Case Report Neurosurgery. 2010;66(3):E620-E622. doi:10.1227/01.NEU.0000365270.23815.B1 Neurosurgery | Copyright © 2010 by the Congress of Neurological Surgeons

FIGURE 4. Intraoperative photograph showing percutaneous pedicle screw towers (Viper II; Depuy Spine) and expandable tubular retractors (Pipeline; Depuy Spine) From: Minimally Invasive Circumferential Spinal Decompression and Stabilization for Symptomatic Metastatic Spine Tumor: Technical Case Report Neurosurgery. 2010;66(3):E620-E622. doi:10.1227/01.NEU.0000365270.23815.B1 Neurosurgery | Copyright © 2010 by the Congress of Neurological Surgeons

FIGURE 5. Six-month follow-up anteroposterior (A) and lateral (C) plain films demonstrating placement of a T1–T3 and T6–T8 pedicle screw and rod construct with expandable cage at T4–T5. Postoperative axial (B), sagittal (D), and coronal (E) computed tomography images demonstrating circumferential decompression and cage placement at T4–T5. From: Minimally Invasive Circumferential Spinal Decompression and Stabilization for Symptomatic Metastatic Spine Tumor: Technical Case Report Neurosurgery. 2010;66(3):E620-E622. doi:10.1227/01.NEU.0000365270.23815.B1 Neurosurgery | Copyright © 2010 by the Congress of Neurological Surgeons