Journal of Neuro-Oncology

, Volume 107, Issue 3, pp 443–455

Emerging techniques in the minimally invasive treatment and management of thoracic spine tumors

  • Zachary A. Smith
  • Isaac Yang
  • Alessandra Gorgulho
  • Dan Raphael
  • Antonio A. F. De Salles
  • Larry T. Khoo
Topic Review

Abstract

Over the past decade, the development and refinement of minimally invasive spine surgery techniques has lead to procedures with the potential to minimize iatrogenic and post-operative sequelae that may occur during the surgical treatment of various pathologies. In a similar manner, parallel advances in other current treatment technologies have led to the development of other minimally invasive treatments of spinal malignancies. These advances include percutaneous techniques for vertebral reconstruction, including vertebroplasty and kyphoplasty, the development of safe and effective spinal radiosurgery, and minimal-access spinal surgical procedures that allow surgeons to safely decompress and reconstruct the anterior spinal column. The advent of these new techniques has given modern practitioners treatment options in situations where they previously were limited by the potentially significant morbidities of the available techniques. Here, the authors discuss the application of current minimally invasive technologies in the treatment of malignancies of the thoracic spine, focusing on vertebral kyphoplasty, spinal radiosurgery, and minimally invasive spinal decompression techniques. The author’s describe how these emerging treatment options are significantly expanding the options open to clinicians in the treatment of thoracic spinal column malignancies. Specific illustrative case examples are provided. The development of these techniques has the potential to improve clinical outcomes, limit surgical morbidity, and also improve the safety and efficiency of treatment pathways.

Keywords

Vertebroplasty Minimally invasive spine Spine surgery Spinal radiosurgery Lateral extracavitary Lateral interbody 

Abbreviations

ALIF

Anterior lumbar interbody fusion

EBRT

External beam radiation therapy

Gy

Gray

IDL

Isodoseline

IMRT

Intensity modulated radiation therapy

LINAC

Linear accelerator

MIS

Minimally invasive spine

OAR

Object at risk

XLIF

eXtreme lateral interbody fusion

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Zachary A. Smith
    • 1
    • 2
  • Isaac Yang
    • 3
  • Alessandra Gorgulho
    • 3
  • Dan Raphael
    • 1
  • Antonio A. F. De Salles
    • 3
    • 4
  • Larry T. Khoo
    • 1
  1. 1.The Spine Clinic of Los Angeles, Affiliate of the University of Southern CaliforniaThe Hospital of the Good SamaritanLos AngelesUSA
  2. 2.Department of Neurological SurgeryNorthwestern UniversityChicagoUSA
  3. 3.Department of NeurosurgeryRonald Reagan-UCLA Medical Center, David Geffen-UCLA School of MedicineLos AngelesUSA
  4. 4.Department of NeurosurgeryWest Los Angeles Veteran’s Administration HospitalLos AngelesUSA

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