Minimally Invasive Spine Surgery for Metastatic Spine Disease
The prevalence of cancer continues to increase as the population ages. More and more people are living with metastatic cancer for which there is no cure but many treatments. The goals of treatments generally focus on extending the life of the patient in the context of maintaining or improving their quality of life. Surgery for the management of spinal metastasis may indirectly increase survival in patients with impending or active neurologic compromise by preventing paralysis. The benefits of preventing paralysis in terms of quality of life are readily apparent as well. However, surgery can be associated with significant morbidity which must be balanced against the potential improvement in quality of life. Furthermore, patients with spinal metastases, by definition, are not curable, and most patients will not survive greater than 1 year. In fact patients with aggressive tumors may only survive a few months and it is undesirable for patients to spend their remaining time recovering from a morbid procedure. Advances in minimally invasive operative techniques combined with improvements in adjuvant therapies such as stereotactic radiosurgery provide an opportunity to render effective treatment for spinal metastases with less morbidity.
KeywordsMinimally spine metastasis Percutaneous pedicle screws Epidural spinal cord compression Stereotactic radiosurgery Pathologic fracture Kyphoplasty Vertebroplasty Metastatic spine Bone metastasis
- 1.American Cancer Society 2013 [Internet]; 2013 [cited November 4]. www.cancer.org.
- 9.Hansen-Algenstaedt N, Kwan MK, Algenstaedt P, Chiu CK, Viezens L, Chan TS, et al. Comparison between minimally invasive surgery and conventional open surgery for patients with spinal metastasis: a prospective propensity score-matched study. Spine (Phila Pa 1976). 2017;42(10):789–97.CrossRefGoogle Scholar
- 10.Laufer I, Iorgulescu JB, Chapman T, Lis E, Shi W, Zhang Z, et al. Local disease control for spinal metastases following “separation surgery” and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients. J Neurosurg Spine. 2013;18(3):207–14.CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Berenson J, Pflugmacher R, Jarzem P, Zonder J, Schechtman K, Tillman JB, et al. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. Lancet Oncol. 2011;12(3):225–35.CrossRefPubMedGoogle Scholar