22nd June 2023

A 51-year-old gentleman with a previous history of a radical nephrectomy three years prior for a T3N0M0 poorly-differentiated renal cell carcinoma

A 51-year-old gentleman with a previous history of a radical nephrectomy three years prior for a T3N0M0 poorly-differentiated renal cell carcinoma presents to the emergency department with a week long history of severe interscapular back pain. No history of trauma is identified. He has no other significant past medical history, and he takes no regular medications. No neurological deficit is identified on examination. Plain film x-rays of the thoracic spine show a wedge fracture of the T4 vertebral body. What is the most important next step?