[Persistent back pain after lifting trauma. From the trivial to the rare case]

A 55-year-old patient presented with persistent back pain after a lifting injury. Later, buttock pain and hypaesthesia of the left knee developed. MRI revealed a lesion at lumbar vertebral body L3, histologically confirmed as a conventional chordoma. Chordomas are rare, locally aggressive tumors of notochordal origin with a high recurrence rate and require specialized treatment. A two-stage en-bloc spondylectomy with dorsal decompression and anterior cage implantation was performed on the patient. Postoperatively, there were motor deficits in hip flexion and knee extension, while distal strength and sensation were preserved. Due to the R1 resection, an additional proton radiation therapy is actually planned.