Early Surgical Experience with Minimally Invasive Percutaneous Approach for Patients with Metastatic Epidural Spinal Cord Compression (MESCC) to Poor Prognoses

Tancioni, Flavio; Navarria, Pierina; Pessina, Federico; Marcheselli, Simona; Rognone, Elisa; Mancosu, P.; Santoro, Armando; Baena, Riccardo Rodriguez y

doi:10.1245/s10434-011-1894-x

Cited by 37 publications

(23 citation statements)

References 26 publications

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“…None of the patients had spinal cord compression. Tancioni et al [40] treated 25 patients with metastatic epidural spinal cord compression with a combination of wide midline laminectomy and percutaneously placed spinal instrumentation. Kyphoplasty was carried out in some patients under open visualization after the decompression.…”

Section: Discussionmentioning

confidence: 99%

Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability

et al. 2015

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“…[2][3] Currently, traditional conservative treatment, traditional surgical treatment and minimally invasive treatment are employed in clinics for the treatment of VCFs. [4][5][6][7][8][9][10] Due to the advantages of smaller incisions, shorter treatment times, reduced pain, and shorter recovery times, minimally invasive treatment has been increasingly used and accepted by surgeons and patients.…”

Section: Introductionmentioning

confidence: 99%

Electrospun Nanofibrous P(DLLA–CL) Balloons as Calcium Phosphate Cement Filled Containers for Bone Repair: in Vitro and in Vivo Studies

Liu

Wei

Zhong

et al. 2015

ACS Appl. Mater. Interfaces

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The spinal surgeon community has expressed significant interest in applying calcium phosphate cement (CPC) for the treatment of vertebral compression fractures (VCFs) and minimizing its disadvantages, such as its water-induced collapsibility and poor mechanical properties, limiting its clinical use. In this work, novel biodegradable electrospun nanofibrous poly(d,l-lactic acid-ϵ-caprolactone) balloons (ENPBs) were prepared, and the separation, pressure, degradation, and new bone formation behaviors of the ENPBs when used as CPC-filled containers in vitro and in vivo were systematically analyzed and compared. CPC could be separated from surrounding bone tissues by ENPBs in vitro and in vivo. ENPB-CPCs (ENPBs serving as CPC-filled containers) exerted pressure on the surrounding bone microenvironment, which was enough to crush trabecular bone. Compared with the CPC implantation, ENPB-CPCs delayed the degradation of CPC (i.e., its water-induced collapsilibity). Finally, possible mechanisms behind the in vivo effects caused by ENPB-CPCs implanted into rabbit thighbones and pig vertebrae were proposed. This work suggests that ENPBs can be potentially applied as CPC-filled containers in vivo and provides an experimental basis for the clinical application of ENPBs for the treatment of VCFs. In addition, this work will be of benefit to the development of polymer-based medical implants in the future.

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“…The pain intensity and functional status were significantly improved without evident cement leakage causing spinal cord compression. Tancioni et al13) treated 25 patients with metastatic epidural spinal cord compression with a combination of decompressive laminectomy and percutaneous instrumentation of screws. Significant pain relief and improved neurological function were also achieved during survival.…”

Section: Discussionmentioning

confidence: 99%

Bone Cement-Augmented Percutaneous Screw Fixation for Malignant Spinal Metastases : Is It Feasible?

Kim

2017

J Korean Neurosurg Soc

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ObjectiveWe evaluated the validity of bone cement-augmented percutaneous screw fixation for treating malignant spinal metastases.MethodsBetween 2011 and 2015, 14 patients (eight men and six women) who underwent bone cement-augmented percutaneous screw fixation for malignant spinal metastases were enrolled in this study. Their life expectancy was considered to be more than one month and less than one year, based on the revised Tokuhashi scoring system. Clinical findings including the back pain scale score, functional outcome, procedure related complications, and survival were assessed preoperatively, postoperatively, and then six months after the procedure.ResultsTwelve of the patients (86%) survived up to six months after the procedure. Three required mini-open decompressive laminectomy for severe epidural compression. Bone cement-augmented percutaneous screw fixation was performed one level above, one level below, and at the pathologic level itself. The mean operation time was 60 minutes (45–180) and blood loss was less than 100 mL. Prior to surgery, the mean pain score on the visual analogue scale was 8.8, while one month after the procedure, it had reduced to 3.0; this improvement was maintained until the six-month assessment in the surviving patients. All patients were able to sit within the first two days after surgery, and no patient experienced neurological deterioration at the one-month follow up after the surgery. No patient experienced screw loosening during the six months of follow-up. Asymptomatic cement leakage into the epidural space was observed in two patients, but no major complications were observed.ConclusionFor selected patients with malignant spinal metastases, bone cement-augmented percutaneous screw fixation can provide significant pain relief and improve quality of life.

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Early Surgical Experience with Minimally Invasive Percutaneous Approach for Patients with Metastatic Epidural Spinal Cord Compression (MESCC) to Poor Prognoses

Cited by 37 publications

References 26 publications

Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability

Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability

Electrospun Nanofibrous P(DLLA–CL) Balloons as Calcium Phosphate Cement Filled Containers for Bone Repair: in Vitro and in Vivo Studies

Bone Cement-Augmented Percutaneous Screw Fixation for Malignant Spinal Metastases : Is It Feasible?

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