Skip to main content
SpringerLink
Log in

Endoscopic Treatment for Spinal Metastases

  • Chapter
  • First Online:
Endoscopy of the Spine

  • 565 Accesses

Abstract

The management of metastatic spine lesions still remains controversial. The goal of surgical treatments of spinal metastases is to achieve decompression of neural elements along with reconstruction and stabilization of the spinal column. Anterior and anterolateral approaches to thoracic and lumbar vertebral metastases are associated with considerable morbidity. Minimally invasive endoscopic approaches have been developed for the surgical treatment of thoracolumbar lesions to overcome the problems associated with anterior approaches. Endoscopic procedures for the surgical treatment of thoracolumbar metastatic spine lesions are being increasingly used. Thoracoscopic procedure provides visualization and magnification of the entire ventral spine from T1 to T12 without the need for open thoracotomy. Interlaminar endoscopic approach and percutaneous transforaminal endoscopic approach are utilized for lesion in the lumbar spine. Minimally invasive endoscopic spinal procedures are reasonable alternatives to treat spinal metastatic disease due to low associated complication rates and short recovery times. The functional and oncologic results are comparable to those of conventional open procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Stephenson MB, Glaenzer B, Malamis A. Percutaneous minimally invasive techniques in the treatment of spinal metastases. Curr Treat Options in Oncol. 2016;17:56.

    Article  Google Scholar 

  2. Sciubba DM, Petteys RJ, Dekutoski MB, et al. Diagnosis and management of metastatic spine disease: a review. J Neurosurg Spine. 2010;13:94–108.

    Article  Google Scholar 

  3. Gokaslan ZL, York JE, Walsh GL, et al. Transthoracic vertebrectomy for metastatic spinal tumors. J Neurosurg. 1998;89:599–609. https://doi.org/10.3171/jns.1998.89.4.0599.

    Article  CAS  Google Scholar 

  4. Bhatt AD, Schuler JC, Boakye M, et al. Current and emerging concepts in non-invasive and minimally invasive management of spine metastasis. Cancer Treat Rev. 2013;39:142–52.

    Article  Google Scholar 

  5. Smith ZA, Yang I, Gorgulho A, et al. Emerging techniques in the minimally invasive treatment and management of thoracic spine tumors. J Neuro-Oncol. 2012;107:443–55.

    Article  Google Scholar 

  6. Miscusi M, Polli FM, Forcato S, Ricciardi L, Frati A, Cimatti M, de Martino L, Ramieri A, Raco A. Comparison of minimally invasive surgery with standard open surgery for vertebral thoracic metastases causing acute myelopathy in patients with short- or mid-term life expectancy: surgical technique and early clinical results. J Neurosurg Spine. 2015;22:518–25.

    Article  Google Scholar 

  7. Klimo P Jr, Kestle JR, Schmidt MH. Clinical trials and evidence-based medicine for metastatic spine disease. Neurosurg Clin N Am. 2004;15:549–64.

    Article  Google Scholar 

  8. Klimo P Jr, Schmidt MH. Surgical management of spinal metastases. Oncologist. 2004;9:188–96.

    Article  Google Scholar 

  9. Yang SB, Cho W, Chang U. Analysis of prognostic factors relating to postoperative survival in spinal metastases. J Korean Neurosurg Soc. 2012;51:127–34.

    Article  Google Scholar 

  10. Pointillart V, Vital J, Salmi R, et al. Survival prognostic factors and clinical outcomes in patients with spinal metastases. J Cancer Res Clin Oncol. 2011;137:849–56.

    Article  Google Scholar 

  11. Quan GM, Vital J, Aurouer N, et al. Surgery improves pain, function and quality of life in patients with spinal metastases: a prospective study on 118 patients. Eur Spine J. 2011;20:1970–8.

    Article  Google Scholar 

  12. Pennington Z, Ahmed AK, Molina CA, Ehresman J, Laufer I, Sciubba DM. Minimally invasive versus conventional spine surgery for vertebral metastases: a systematic review of the evidence. Ann Transl Med. 2018;6(6):103–17.

    Article  Google Scholar 

  13. Harel R, Angelov L. Spine metastases: current treatments and future directions. Eur J Cancer. 2010;46:2696–707.

    Article  Google Scholar 

  14. Schmidt MH, Klimo P Jr, Vrionis FD. Metastatic spinal cord compression. J Natl Compr Cancer Netw. 2005;3:711–9.

    Article  Google Scholar 

  15. Patchell RA, Tibbs PA, Regine WF, Payne R, Saris S, Kryscio RJ, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet. 2005;366:643–8.

    Article  Google Scholar 

  16. Klimo P Jr, Thompson CJ, Kestle JR, Schmidt MH. A meta-analysis of surgery versus conventional radiotherapy for the treatment of metastatic spinal epidural disease. Neuro-oncol. 2005;7:64–76.

    Article  Google Scholar 

  17. Anand N, Regan JJ. Video-assisted thoracoscopic surgery for thoracic disc disease: classification and outcome study of 100 consecutive cases with a 2-year minimum follow-up period. Spine. 2002;27:871–9.

    Article  Google Scholar 

  18. Beisse R. Video-assisted techniques in the management of thoracolumbar fractures. Orthop Clin North Am. 2007;38:419–29.

    Article  Google Scholar 

  19. Beisse R, Muckley T, Schmidt MH, Hauschild M, Buhren V. Surgical technique and results of endoscopic anterior spinal canal decompression. J Neurosurg Spine. 2005;2:128–36.

    Article  Google Scholar 

  20. Han PP, Kenny K, Dickman CA. Thoracoscopic approaches to the thoracic spine: experience with 241 surgical procedures. Neurosurgery. 2002;51(5 Suppl):88–95.

    Google Scholar 

  21. Kan P, Schmidt MH. Minimally invasive thoracoscopic approach for anterior decompression and stabilization of metastatic spine disease. Neurosurg Focus. 2008;25(2):E8.

    Article  Google Scholar 

  22. Oskouian RJ, Johnson JP. Endoscopic thoracic microdiscectomy. J Neurosurg Spine. 2005;3:459–64.

    Article  Google Scholar 

  23. Schultheiss M, Kinzl L, Claes L, Wilke HJ, Hartwig E. Minimally invasive ventral spondylodesis for thoracolumbar fracture treatment: surgical technique and first clinical outcome. Eur Spine J. 2003;12:618–24.

    Article  Google Scholar 

  24. Gottfried ON, Schloesser PE, Schmidt MH, Stevens EA. Embolization of metastatic spinal tumors. Neurosurg Clin N Am. 2004;15:391–9.

    Article  Google Scholar 

  25. Fourney DR, Gokaslan ZL. Anterior approaches for thoracolumbar metastatic spine tumors. Neurosurg Clin N Am. 2004;15:443–51.

    Article  Google Scholar 

  26. Bohm P, Huber J. The surgical treatment of bony metastases of the spine and limbs. J Bone Joint Surg Br. 2002;84:521–9.

    Article  CAS  Google Scholar 

  27. Gao Z, Wu Z, Lin Y, Zhang P. Percutaneous transforaminal endoscopic decompression in the treatment of spinal metastases: a case report. Medicine (Baltimore). 2019 Mar;98(11):e14819.

    Article  Google Scholar 

  28. Tsai SH, Wu HH, Cheng CY, Chen CM. Full Endoscopic Interlaminar Approach for Nerve Root Decompression of Sacral Metastatic Tumor. World Neurosurg. 2018 Apr;112:57–63.

    Article  Google Scholar 

  29. McLain RF. Spinal cord decompression: an endoscopically assisted approach for metastatic tumors. Spinal Cord. 2001 Sep;39(9):482–7.

    Article  CAS  Google Scholar 

  30. Telfeian AE, Oyelese A, Fridley J, Doberstein C, Gokaslan ZL. Endoscopic surgical treatment for symptomatic spinal metastases in long-term cancer survivors. J Spine Surg. 2020 Jun;6(2):372–82.

    Article  Google Scholar 

Download references

Acknowledgments

We are grateful to Meic H. Schmidt, MD, MBA, FAANS, FACS, Professor and Chair of Neurosurgery at the University of New Mexico, USA, for the permission to use Figs. 48.3, 48.4, and 48.5 as intraoperative images taken as screenshots from his video named “Thoracoscopic transdiaphagmatic approach to treat metastatic spinal cord compression.” Video link: https://youtu.be/w8fanV9bq-E.

Author information

Authors and Affiliations

  1. Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, University Clinical Center of Serbia, Belgrade, Serbia

    Lukas Rasulić

  2. Department of Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia

    Lukas Rasulić

  3. Department of Neurosurgery, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia

    Krešimir Rotim & Tomislav Sajko

  4. Department of Anatomy and Physiology, University of Applied Health Sciences, Zagreb, Croatia

    Krešimir Rotim & Tomislav Sajko

  5. Department of Neurology and Neurosurgery, Medical School, University of Osijek, Osijek, Croatia

    Krešimir Rotim & Tomislav Sajko

Authors
  1. Lukas Rasulić
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Krešimir Rotim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomislav Sajko
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lukas Rasulić .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong, China

    Tun Hing Lui

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rasulić, L., Rotim, K., Sajko, T. (2023). Endoscopic Treatment for Spinal Metastases. In: Lui, T.H. (eds) Endoscopy of the Spine. Springer, Singapore. https://doi.org/10.1007/978-981-19-7761-9_48

Download citation

  • DOI: https://doi.org/10.1007/978-981-19-7761-9_48

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-7760-2

  • Online ISBN: 978-981-19-7761-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation