Spinal Metastasis - pedicle screw fixation and Vertebroplasty This 68 year old male presented to us with Back pain since 10 days after a fall. His MRI showed a fracture of D10 vertebra with soft tissue component presing on the spinal cord. MRI was sugestive of Pathological fracture probably due to Metastasis. PET CT was done which showed Renal mass sugestive of Renal cell carcinoma. After consultations with Oncologist, a plan was made to first do decompression, Pedicle screw fixation and biopsy. Prior to surgery embolisation of tumour mass was done followed by Spinal surgery. Pedicle screw fixation was done and vertebroplasty was done in fractured vertebra. patient tolerated the surgery well and was discharged after 4 days.