Case: A 64-year-old woman with a history of World Health Organization Grade II (Ki-67 20%) atypical meningioma presented with T12 vertebral body burst fracture as a complication of metastatic meningioma (SSTR2+). Following disease progression, decompression surgery and stabilization through T10-L2 posterior thoracolumbar instrumented fusion was performed.
Conclusion: This is one of few documented cases of spinal metastatic meningioma causing pathological fracture and the first to detail surgical management and longitudinal follow-up. Applying the neurologic, oncologic, mechanical, and systemic decision framework to this rare presentation, the patient was indicated for the selected surgical approach, yielding short-term improvement of patient outcome and neurologic deficit.
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