Spinal metastases from testicular non-seminomatous germ cell tumors (NSGCTs) are extremely rare and may require complex surgical strategies. This case aims to illustrate the role of robot-assisted spine surgery (RASS) in achieving oncological resection and spinal stabilization in the context of vertebral invasion. A 33-year-old male with metastatic NSGCT presented with localized L3 vertebral involvement. A two-stage surgical approach was performed. The first stage involved posterior decompression and vertebral resection. Pedicle screw placements and osteotomies were performed under robot-assisted guidance. The second stage consisted of anterior tumor and vertebral body resection via laparotomy, followed by expandable titanium cage placement. Complete vertebrectomy and tumor resection were achieved with no postoperative neurological deficits. The robot-assisted technique allowed precise execution of complex osteotomies and stabilization in accordance with preoperative planning. RASS is a valuable adjunct in the management of spinal metastases, helping to achieve radical oncologic goals while preserving neurological function and spinal stability.
Keraudy et al. (Sat,) studied this question.