A Systematic Review of the Current Role of Minimally Invasive Spine Surgery in the Management of Metastatic Spine Disease

Molina, Camilo A.; Gokaslan, Ziya L.; Sciubba, Daniel M.

doi:10.1155/2011/598148

Cited by 43 publications

(50 citation statements)

References 50 publications

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“…39 There have been technical reports and cadaver studies of MIS posterior-only corpectomies, but there are few clinical reports of utilizing the technique in the treatment for spinal metastasis. 36,40 Taghva et al re- ported the use of MIS via expandable tubular retractors in the treatment of a 36-year-old man with metastatic lung adenocarcinoma to the spine.…”

Section: Discussionmentioning

confidence: 99%

Posterior thoracic corpectomy with cage reconstruction for metastatic spinal tumors: comparing the mini-open approach to the open approach

Lau¹,

Chou²

2015

SPI

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OBJECT Spinal metastases most commonly affect the vertebral bodies of the spinal column, and spinal cord compression is an indication for surgery. Commonly, an open posterior approach is employed to perform a transpedicular costotransversectomy or lateral extracavitary corpectomy. Because of the short life expectancies in patients with metastatic spinal disease, decreasing the morbidity of surgical treatment and recovery time is critical. One potential approach to decreasing morbidity is utilizing minimally invasive surgery (MIS). Although significant advances have been made in MIS of the spine, data supporting the utility of MIS are still emerging. This study compared outcomes of patients who underwent mini-open versus traditional open transpedicular corpectomy for spinal metastases in the thoracic spine. METHODS A consecutive cohort from 2006 to 2013 of 49 adult patients who underwent thoracic transpedicular corpectomies for spinal metastases was retrospectively identified. Patients were categorized into one of 2 groups: open surgery and mini-open surgery. Mini-open transpedicular corpectomy was performed with a midline facial incision over only the corpectomy level of interest and percutaneous instrumentation above and below that level. The open procedure consisted of a traditional posterior transpedicular corpectomy. Chi-square test, 2-tailed t-test, and ANOVA models were employed to compare perioperative and follow-up outcomes between the 2 groups. RESULTS In the analysis, there were 21 patients who had mini-open surgery and 28 patients who had open surgery. The mean age was 57.9 years, and 59.2% were male. The tumor types encountered were lung (18.3%), renal/bladder (16.3%), breast (14.3%), hematological (14.3%), gastrointestinal tract (10.2%), prostate (8.2%), melanoma (4.1%), and other/unknown (14.3%). There were no significant intergroup differences in demographics, comorbidities, neurological status (American Spinal Injury Association [ASIA] grade), number of corpectomies performed, and number of levels instrumented. The open group had a mean operative time of 413.6 minutes, and the mini-open group had a mean operative time of 452.4 minutes (p = 0.329). Compared with the open group, the mini-open group had significantly less blood loss (917.7 ml vs 1697.3 ml, p = 0.019) and a significantly shorter hospital stay (7.4 days vs 11.4 days, p = 0.001). There was a trend toward a lower perioperative complication rate in the mini-open group (9.5%) compared with the open group (21.4%), but this was not statistically significant (p = 0.265). At follow-up, there were no significant differences in ASIA grade (p = 0.342), complication rate after the 30-day postoperative period (p = 0.999), or need for surgical revision (p = 0.803). The open approach had a higher overall infection rate of 17.9% compared with that in the mini-open approach of 9.5%, but this was not statistically significant (p = 0.409). CONCLUSIONS The mini-open transpedicular corpectomy is associated with less blood loss and shorter hospital stay compared with open transpedicular corpectomy. The mini-open corpectomy also trended toward lower infection and complication rates, but these did not reach statistical significance.

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Section: Discussionmentioning

confidence: 99%

Posterior thoracic corpectomy with cage reconstruction for metastatic spinal tumors: comparing the mini-open approach to the open approach

Lau¹,

Chou²

2015

SPI

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“…In a recent review of the literature, Molina et al 8 found only 11 publications that addressed minimally invasive surgery in the treatment of metastatic spine disease. Most of these publications were case reports or limited retrospective case series that reported the efficiency of video-assisted or minimally invasive anterior approaches.…”

Section: Clinical Efficiencymentioning

confidence: 99%

“…10 Longer hospital stays are indicative of increased patient morbidity. In the review of Molina et al, 8 decreased complication rates, blood loss, and length of hospital stay are believed to be among the benefits of minimally invasive approaches. These benefits were confirmed by our results when compared with gath-ered data outcomes for standard surgery.…”

Section: Morbidity and Complicationsmentioning

confidence: 99%

Minimally invasive decompression and stabilization for the management of thoracolumbar spine metastasis

Zaïri¹,

Arikat²,

Allaoui³

et al. 2012

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“…Similarly, our review of the VATS and MASS literature for anterior T and TLJ spinal reconstruction showed that VATS was more likely to need operating time and to increase blood loss. In addition, Molina et al [32], in a systematic review of MIS in the management of metastatic spine disease, reported that VATS was associated with longer operating time, a longer length of stay in the hospital, and more blood loss than was MASS. We found that since MASS seems more familiar to most surgeons it yields faster and safer decompression, stabilization, and reconstruction than does VATS.…”

Section: Discussionmentioning

confidence: 99%

Video-Assisted Thoracoscopic Surgery and Minimal Access Spinal Surgery Compared in Anterior Thoracic or Thoracolumbar Junctional Spinal Reconstruction: A Case-Control Study and Review of the Literature

Lee

et al. 2016

BioMed Research International

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There are no published reports that compare the outcomes of video-assisted thoracoscopic surgery (VATS) and minimal access spinal surgery (MASS) in anterior spinal reconstruction. We conducted a retrospective case-control study in a single center and systematically reviewed the literature to compare the efficacy and safety of VATS and MASS in anterior thoracic (T) and thoracolumbar junctional (TLJ) spinal reconstruction. From 1995 to 2012, there were 111 VATS patients and 76 MASS patients treated at our hospital. VATS patients had significantly (p < 0.001) longer operating times and significantly (p < 0.022) higher thoracotomy conversion rates. We reviewed 6 VATS articles and 10 MASS articles, in which there were 625 VATS patients and 399 MASS patients. We recorded clinical complications and a thoracotomy conversion rate from our cases and the selected articles. The incidence of approach-related complications was significantly (p = 0.021) higher in VATS patients. The conversion rate was 2% in VATS patients and 0% in MASS patients (p = 0.001). In conclusion, MASS is associated with reduction in operating time, approach-related complications, and the thoracotomy conversion rate.

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A Systematic Review of the Current Role of Minimally Invasive Spine Surgery in the Management of Metastatic Spine Disease

Cited by 43 publications

References 50 publications

Posterior thoracic corpectomy with cage reconstruction for metastatic spinal tumors: comparing the mini-open approach to the open approach

Posterior thoracic corpectomy with cage reconstruction for metastatic spinal tumors: comparing the mini-open approach to the open approach

Minimally invasive decompression and stabilization for the management of thoracolumbar spine metastasis

Video-Assisted Thoracoscopic Surgery and Minimal Access Spinal Surgery Compared in Anterior Thoracic or Thoracolumbar Junctional Spinal Reconstruction: A Case-Control Study and Review of the Literature

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