Journal
WORLD NEUROSURGERY
Volume 157, Issue -, Pages 170-+Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2021.10.086
Keywords
Metastases; Spine; Spine oncology; Spine surgery
Categories
Ask authors/readers for more resources
This study reviewed a 10-year trend in the surgical management of spinal metastases, finding that minimally invasive techniques for decompression and stabilization seem to be the preferred method to surgically treat metastatic spine disease, with good outcomes. More research with high level of evidence is required to support the long-term outcomes of these approaches.
BACKGROUND: Spinal metastases are present in approximately 20% of patients with cancer, giving a risk for neurologic dysfunction and instability. In already frail patients, surgeons strive to improve quality of life. Our goal was to review a 10-year trend in the surgical management of spinal metastases. - METHODS: A scoping review was performed systematically using PubMed to assess trends in surgical treatment for spinal metastases. The search terms used were: metastas*, neoplasm metastasis[Mesh], Spine[Mesh], spine, spinal, vertebral column, vertebral body, laser, robot, radiofrequency, screws, fixation, separation surgery, corpectomy, vertebrectomy, spondylectomy, vertebroplasty, kyphoplasty, surgery, open surgery, mini open surgery, minimally invasive surgery, endoscopy, thoracoscopy, corpectom*, vertebrectom*, spondylectom*, en bloc, and MIS. The variables of interest were neurologic improvement, tumor recurrence, reoperation, and overall survival. RESULTS: A total of 2132 articles were found within the primary query. Fiftysix studies were selected for final review. The results were organized into main surgical practices: decompression, mechanical stabilization, and pain management. For separation surgery, clinical outcomes were overall 1-year survival, 40.7%-78.4%; recurrence rate, 4.3%-22%; reoperation, 5%; and complications, 5.4%-14%. For corpectomy, clinical outcomes were overall 1-year survival, 30%-92%; reoperation, 1.1%-50%; and recurrence rate, of 1.1%-28%. Complications and reoperations with spinal instrumentation were 0%-13.6% and 0%15%, respectively. Cement augmentation achieved pain reduction rates of 56%100%, neurologic improvement/stability 84%-100%, and complication rates 6%56%. Laser achieved local tumor control rate of 71%-82% at 1 year follow-up, reoperation rate of 15%-31%, and complication rate of 5%-26%. CONCLUSIONS: Minimally invasive techniques for decompression and stabilization seem to be the preferred method to surgically treat metastatic spine disease, with good outcomes. More research with high level of evidence is required to support the long-term outcomes of these approaches.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available