Comparison Between Minimally Invasive Surgery and Conventional Open Surgery for Patients With Spinal Metastasis

Hansen-Algenstaedt, Nils; Kwan, Mun Keong; Algenstaedt, Petra; Chiu, Chee Kidd; Viezens, Lennart; Chan, Teik Seng; Lee, Chee Kean; Wellbrock, Jasmin; Chan, Chris Yin Wei; Schaefer, Christian

doi:10.1097/brs.0000000000001893

Cited by 84 publications

(61 citation statements)

References 46 publications

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“…In the review by Pennington et al, the authors analyzed the same six studies along with two further retrospective cohort studies, thereby including further 21 patients, and concluded that the level of the available evidence is low (25,26). Both studies emphasize a well-designed study by Hansen-Algenstaedt et al (19). In this study, the authors compared 30 patients treated with OS with 30 patients treated with MASS.…”

Section: Discussionmentioning

confidence: 97%

“…Two recent systematic reviews have compared minimal access surgery with open surgery in patients suffering from MSCC (7,8). Lu et al included six cohort studies (three prospective and three retrospective) representing a total of 252 patients (19)(20)(21)(22)(23)(24). Lu et al concluded that are many surgical advantages to the use of MASS compared with OS, such as reduced blood loss and fewer complications, however, future larger cohort studies and future randomized trials are needed to validate the findings.…”

Section: Discussionmentioning

confidence: 99%

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Minimal Accessvs.Open Spine Surgery in Patients With Metastatic Spinal Cord Compression - A One–Center Randomized Controlled Trial

et al. 2020

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Background/Aim: We conducted a randomized controlled trial to investigate whether minimally access spine surgery (MASS) is less morbid than open surgery (OS) in patients with metastatic spinal cord compression (MSCC). Patients and Methods: A total of 49 MSCC patients were included in the trial. The outcome measures were bleeding (L), operation time (min), re-operations and prolonged wound healing. Results: The median age was 67 years (range=42-85 years) and 40% were men. The peri-operative blood loss in the MASS-group was significantly lower than that in the OS-group; 0.175L vs. 0.500L, (p=0.002). The median operation time for MASS was 142 min (range=72-203 min) vs. 103 (range=59-435 min) for OS (p=0.001). There was no significant difference between the two groups concerning revision surgery or delayed wound healing. Conclusion: The MASS technique in MSCC patients is associated with less blood loss, but a longer operation time when compared to the OS technique. In recent years, an increasing number of cancer patients develop symptomatic metastatic spinal cord compression (MSCC). This is most likely a result of the advancement in cancer treatment and prolonged survival among cancer patients in general (1, 2). The optimal treatment for MSCC patients is considered to be surgery in combination with radiation therapy (3, 4). However, the majority of patients are not recommended surgical treatment due to poor health and relatively short survival time, which means that they cannot withstand large surgical procedures (5, 6). Minimally access spine surgery (MASS) is considered less morbid than open surgery (OS), and results in fewer wound complications and less bleeding. The existing evidence for bleeding in minimal versus open surgery from observational studies is gathered in two recently published reviews by Pennington and colleagues and by Lu and colleagues. The conclusions were that "The overall quality of evidence currently available is low-all evidence is currently class III or IV" (7, 8). With this clinical trial we aimed to examine the perioperative bleeding, surgery time and number of revisions of MASS compared with conventional OS in the treatment of patients with MSCC. The hypothesis of the study was that MASS results in significantly less blood loss, shorter surgery time and fewer revisions when compared to open surgery. Patients and Methods Study population. The study includes MSCC patients admitted to Rigshospitalet, Denmark from January 1 st , 2014 to January 1 st , 2017. The hospital serves a population of 2.3 million people from the eastern part of Denmark. The MSCC diagnosis was based on magnetic resonance imaging (MRI) in combination with clinical symptoms such as back pain and/or neurological impairment. Patients with MSCC between T5 to L3 where included. Patients with Tokuhashi score ≤4, in need of sacral or iliosacral instrumentation, and patients who were candidates for a corpectomy were excluded. All patients were included in the study at referral and information regarding age, sex, primary oncolog...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Minimal Accessvs.Open Spine Surgery in Patients With Metastatic Spinal Cord Compression - A One–Center Randomized Controlled Trial

et al. 2020

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“…In recent years, the application of minimally invasive interventional therapy in cardiothoracic, orthopedics, vascular, and other operations has been received extensive attention with the increasing risk control requirements in clinical surgery. [1][2][3][4][5] Compared with traditional large incision or open surgery, the minimally invasive interventional surgery has the advantages of less side effects, less trauma, faster recovery, and stronger targetability. 6,7 As a typical minimally invasive interventional surgery, percutaneous puncture is widely applied in occasions like human-tissue biopsy or directed drug treatment.…”

Section: Introductionmentioning

confidence: 99%

Lesion positioning method of a CT‐guided surgical robotic system for minimally invasive percutaneous lung

Zhang

Wang

et al. 2020

Robotics Computer Surgery

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Background Robot‐assisted puncture has gradually attracted more attention and practical clinical application. The lesion positioning and the needle positioning are the basis to ensure the accuracy of puncture and the key techniques in insertion operation. Methods A lesion positioning method is established which is realized only by the robot‐CT system without using external positioning system, and an omnidirectional needle positioning method is also developed and realized by using VRCM, in order to make the puncture needle always keep pointing to the lesion point. A CT‐guided surgical robotic system used for minimally invasive percutaneous lung is designed and the physical prototype is manufactured, to perform in‐vitro experiments, thereby to validate the effectiveness of the lesion positioning method and the feasibility of omnidirectional needle positioning method. Results The accuracy of established lesion positioning method based on three non‐collinear markers is within 3 mm, which is similar to that of the least squares method based on the five non‐coplanar markers, but the positioning efficiency can be improved by about 40%, and the non‐collinearity of markers is easier to be satisfied than non‐coplanarity in practical applications. The average calculation error of the established positioning method is 0.997 mm. Moreover, the omnidirectional positioning of the puncture needle under the designed surgical robot is feasible. Conclusions The designed surgical robot has good control accuracy and it can satisfy the requirements for use. The established lesion positioning method can provide a good precision basis for robot‐assisted puncture surgery. The suitable insertion point and insertion posture can be determined by the developed omnidirectional needle positioning method. This study can provide theoretical reference for further study of path planning or autonomous positioning.

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“…In modern medical technology, minimally invasive surgery and local treatment surgery play an important role. As a minimally invasive interventional surgery, puncture biopsy has the advantages of being less traumatic and having strong targeting, an aspect common in modern surgery, such as in tissue biopsies and targeted drug therapy [1][2][3][4]. Puncture biopsy sampling is the main method to obtain tumor tissue and make a pathological diagnosis [5].…”

Section: Introductionmentioning

confidence: 99%

Influence of a Biocompatible Hydrophilic Needle Surface Coating on a Puncture Biopsy Process for Biomedical Applications

et al. 2020

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A puncture biopsy is a widely used, minimally invasive surgery process. During the needle insertion process, the needle body is always in direct contact with a biological soft tissue. Tissue adhesion and different degrees of tissue damage occur frequently. Optimization of the needle surface, and especially the lubrication of the needle surface, can deal with these problems efficiently. Therefore, in this paper, a biocompatible hydrophilic coating was applied onto the surface of a needle to improve the surface quality of the needle surface. Further, a simplified finite element model of insertion was established, and extracorporeal insertion experiments were used to verify the accuracy of the model. Then, by analyzing a simulation model of a coated needle and a conventional needle, the influence of the application of the coated needle on the insertion process was obtained. It can be seen from the results that the coating application relieved the force on the needle and the soft tissue during the insertion process and could significantly reduce friction during the insertion process. At the same time, the deformation of biological soft tissue was reduced, and the adhesion situation between the needle and tissue improved, which optimized the puncture needle.

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Comparison Between Minimally Invasive Surgery and Conventional Open Surgery for Patients With Spinal Metastasis

Abstract: 3.

Cited by 84 publications

References 46 publications

Minimal Accessvs.Open Spine Surgery in Patients With Metastatic Spinal Cord Compression - A One–Center Randomized Controlled Trial

Minimal Accessvs.Open Spine Surgery in Patients With Metastatic Spinal Cord Compression - A One–Center Randomized Controlled Trial

Lesion positioning method of a CT‐guided surgical robotic system for minimally invasive percutaneous lung

Influence of a Biocompatible Hydrophilic Needle Surface Coating on a Puncture Biopsy Process for Biomedical Applications

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