Evaluation of open and minimally invasive spinal surgery for the treatment of thoracolumbar metastatic epidural spinal cord compression: a systematic review.
Corpectomy
Metastasis
Metastatic epidural spinal cord compression
Minimally invasive spine
Spine surgery
Thoracolumbar
Journal
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
26
02
2021
accepted:
13
05
2021
pubmed:
31
5
2021
medline:
25
2
2023
entrez:
30
5
2021
Statut:
ppublish
Résumé
Metastatic epidural spinal cord compression (MESCC) is a debilitating sequela of cancer that results in pain, disability, and neurologic deficits. Surgical techniques have included open surgical (OS) techniques with anterior and/or posterior decompression and fusion procedures. Further technical evolution has led to minimally invasive spinal (MIS) decompression and fusion. The objective of this study is to compare MIS to OS techniques in the treatment of thoracolumbar MESCC. A review of the literature was performed using PubMed database. Inclusion criteria included patients 18 years or older, thoracolumbar MESCC, and surgeries with instrumented fusion. A total of 451 articles met the inclusion criteria and further analysis narrowed them down to 81 articles. Variables collected included blood loss, length of stay, operative time, pre- and postoperative Frankel grade, and complications. A total of 5726 papers were collected, with a total of 81 papers meeting final inclusion criteria: 26 papers with MIS technique and 55 with OS. A total of 2267 patients were evaluated. They were split into three surgical subtypes of MIS and OS: posterior decompression and fusion, partial corpectomy, and complete corpectomy. Overall, MIS had lower operative time, blood loss, and complications compared to OS. A timeline analysis showed reduction of complication rates in MIS surgery between papers published over a 28-year period. MESCC carries significant morbidity and mortality. Surgical approaches for palliative treatment should account for this fact. We conclude that MIS techniques offer a viable alternative to traditional OS approaches with lower overall morbidity and complications.
Sections du résumé
BACKGROUND
Metastatic epidural spinal cord compression (MESCC) is a debilitating sequela of cancer that results in pain, disability, and neurologic deficits. Surgical techniques have included open surgical (OS) techniques with anterior and/or posterior decompression and fusion procedures. Further technical evolution has led to minimally invasive spinal (MIS) decompression and fusion. The objective of this study is to compare MIS to OS techniques in the treatment of thoracolumbar MESCC.
METHODS
A review of the literature was performed using PubMed database. Inclusion criteria included patients 18 years or older, thoracolumbar MESCC, and surgeries with instrumented fusion. A total of 451 articles met the inclusion criteria and further analysis narrowed them down to 81 articles. Variables collected included blood loss, length of stay, operative time, pre- and postoperative Frankel grade, and complications.
RESULTS
A total of 5726 papers were collected, with a total of 81 papers meeting final inclusion criteria: 26 papers with MIS technique and 55 with OS. A total of 2267 patients were evaluated. They were split into three surgical subtypes of MIS and OS: posterior decompression and fusion, partial corpectomy, and complete corpectomy. Overall, MIS had lower operative time, blood loss, and complications compared to OS. A timeline analysis showed reduction of complication rates in MIS surgery between papers published over a 28-year period.
CONCLUSION
MESCC carries significant morbidity and mortality. Surgical approaches for palliative treatment should account for this fact. We conclude that MIS techniques offer a viable alternative to traditional OS approaches with lower overall morbidity and complications.
Identifiants
pubmed: 34052895
doi: 10.1007/s00586-021-06880-7
pii: 10.1007/s00586-021-06880-7
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2906-2914Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Klimo P Jr, Schmidt MH (2004) Surgical management of spinal metastases. Oncol 9:188–196. https://doi.org/10.1634/theoncologist.9-2-188
doi: 10.1634/theoncologist.9-2-188
Wong DA, Fornasier VL, MacNab I (1990) Spinal metastases: the obvious, the occult, and the impostors. Spine 15:1–4
doi: 10.1097/00007632-199001000-00001
Patchell RA, Tibbs PA, Regine WF, Payne R, Saris S, Kryscio RJ, Mohiuddin M, Young B (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366:643–648. https://doi.org/10.1016/S0140-6736(05)66954-1
doi: 10.1016/S0140-6736(05)66954-1
pubmed: 16112300
Liu A, Sankey EW, Goodwin CR, Kosztowski TA, Elder BD, Bydon A, Witham TF, Wolinsky JP, Gokaslan ZL, Sciubba DM (2016) Postoperative survival and functional outcomes for patients with metastatic gynecological cancer to the spine: case series and review of the literature. J Neurosurg Spine 24:131–144. https://doi.org/10.3171/2015.3.SPINE15145
doi: 10.3171/2015.3.SPINE15145
pubmed: 26360144
Kan P, Schmidt MH (2008) Minimally invasive thoracoscopic approach for anterior decompression and stabilization of metastatic spine disease. Neurosurg Focus 25:E8. https://doi.org/10.3171/FOC/2008/25/8/E8
doi: 10.3171/FOC/2008/25/8/E8
pubmed: 18673056
Kumar N, Malhotra R, Maharajan K, Zaw AS, Wu PH, Makandura MC, Po Liu GK, Thambiah J, Wong HK (2017) Metastatic spine tumor surgery: a comparative study of minimally invasive approach using percutaneous pedicle screws fixation versus open approach. Clin Spine Surg 30:E1015–E1021. https://doi.org/10.1097/BSD.0000000000000400
doi: 10.1097/BSD.0000000000000400
pubmed: 27352374
Lu DC, Chou D, Mummaneni PV (2011) A comparison of mini-open and open approaches for resection of thoracolumbar intradural spinal tumors. J Neurosurg Spine 14:758–764. https://doi.org/10.3171/2011.1.SPINE09860
doi: 10.3171/2011.1.SPINE09860
pubmed: 21395392
Uribe JS, Dakwar E, Le TV, Christian G, Serrano S, Smith WD (2010) Minimally invasive surgery treatment for thoracic spine tumor removal: a mini-open, lateral approach. Spine 35:S347–S354. https://doi.org/10.1097/BRS.0b013e3182022d0f
doi: 10.1097/BRS.0b013e3182022d0f
pubmed: 21160399
Alshareef MA, Klapthor G, Lowe SR, Barley J, Cachia D, Frankel BM (2020) Strategies for posterior-only minimally invasive surgery in thoracolumbar metastatic epidural spinal cord compression. Surg Neurol Int 11:462. https://doi.org/10.25259/SNI_815_2020
doi: 10.25259/SNI_815_2020
pubmed: 33408947
pmcid: 7771402
Molina CA, Gokaslan ZL, Sciubba DM (2011) A systematic review of the current role of minimally invasive spine surgery in the management of metastatic spine disease. Int J Surg Oncol 2011:598148. https://doi.org/10.1155/2011/598148
doi: 10.1155/2011/598148
pubmed: 22312514
pmcid: 3263667
Tokuhashi Y, Uei H, Oshima M, Ajiro Y (2014) Scoring system for prediction of metastatic spine tumor prognosis. World J Orthop 5:262–271. https://doi.org/10.5312/wjo.v5.i3.262
doi: 10.5312/wjo.v5.i3.262
pubmed: 25035829
pmcid: 4095019
Tomita K, Kawahara N, Kobayashi T, Yoshida A, Murakami H, Akamaru T (2001) Surgical strategy for spinal metastases. Spine 26:298–306. https://doi.org/10.1097/00007632-200102010-00016
doi: 10.1097/00007632-200102010-00016
pubmed: 11224867
Binning MJ, Gottfried ON, Klimo P Jr, Schmidt MH (2004) Minimally invasive treatments for metastatic tumors of the spine. Neurosurg Clin N Am. 15:459–465. https://doi.org/10.1016/j.nec.2004.04.010
doi: 10.1016/j.nec.2004.04.010
pubmed: 15450881
Keshavarzi S, Park MS, Aryan HE, Newman CB, Amene CS, Gonda D, Taylor WR (2009) Minimally invasive thoracic corpectomy and anterior fusion in a patient with metastatic disease: case report and review of the literature. Minim Invasive Neurosurg 52:141–143. https://doi.org/10.1055/s-0029-1231067
doi: 10.1055/s-0029-1231067
pubmed: 19650018
Regan JJ, Yuan H, McAfee PC (1999) Laparoscopic fusion of the lumbar spine: minimally invasive spine surgery. a prospective multicenter study evaluating open and laparoscopic lumbar fusion. Spine 24:402–411. https://doi.org/10.1097/00007632-199902150-00023
doi: 10.1097/00007632-199902150-00023
pubmed: 10065526
Regan JJ, Aronoff RJ, Ohnmeiss DD, Sengupta DK (1999) Laparoscopic approach to L4–L5 for interbody fusion using BAK cages: experience in the first 58 cases. Spine 24:2171–2174. https://doi.org/10.1097/00007632-199910150-00018
doi: 10.1097/00007632-199910150-00018
pubmed: 10543017
Katoh H, Yamashita K, Kokuba Y, Satoh T, Ozawa H, Hatate K, Ihara A, Nakamura T, Onosato W, Watanabe M (2008) Surgical resection of stage IV colorectal cancer and prognosis. World J Surg 32:1130–1137. https://doi.org/10.1007/s00268-008-9535-7
doi: 10.1007/s00268-008-9535-7
pubmed: 18340483
Paulino Pereira NR, Janssen SJ, van Dijk E, Harris MB, Hornicek FJ, Ferrone ML, Schwab JH (2016) Development of a prognostic survival algorithm for patients with metastatic spine disease. J Bone Jt Surg 98:1767–1776. https://doi.org/10.2106/JBJS.15.00975
doi: 10.2106/JBJS.15.00975