Low Implant Failure Rate of Percutaneous Fixation for Spinal Metastases: A Multicenter Retrospective Study

Silva, Álvaro; Yurac, Ratko; Guiroy, Alfredo; Bravo, O; Ciancio, Alejandro Morales; Landriel, Federico; Hem, Santiago

doi:10.1016/j.wneu.2021.01.047

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…Traditionally, complication rates are higher in patients undergoing corpectomy compared to separation surgery, but both surgeries have wide ranges reported in the literature. The complication rate in this study (n=9, 14.2%) was lower than the corpectomy complication rates reported by Gokaslan et [40,41]. No patients had long-term surgical complications nor did any patients die within 30 days of surgery for reasons related to their surgery.…”

Section: Complicationscontrasting

confidence: 64%

Survival and Neurological Outcomes Following Corpectomy for Spinal Metastatic Disease: A Single Institutional Experience

Chowdhury,

Teferi,

Lee

et al. 2024

Preprint

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Background: The incidence of spinal metastatic disease has risen with improved cancer survivorship. Separation surgery, the current standard surgical treatment, does not fully address spinal deformity. Advances in operative management warrant reevaluating maximal tumor resection and anterior column reconstruction with corpectomy. Methods: An IRB-approved retrospective single-center review of 63 patients was performed. Demographics, tumor characteristics, clinical and radiographic data, treatments, and neurological and survival outcomes were analyzed. Results: The mean age at presentation was 63.5 ± 9.6 years (range, 37-84 years) and 28 patients (44.4%) were female. Functional outcomes, measured by KPS, RAND-36 survey scores and Oswestry Disability Index all improved postoperatively (pre- vs postop: 70 to 80 (p=0.0056), 26.5 to 46.4 (p=0.0081), and 28.9 to 16.9 (p=0.0613), respectively). Spinal alignment also improved, with Cobb angle measurements showing a reduction in spinal kyphosis from -5 to 0 (p=0.021). Nine patients (14.5%) had non-fatal postoperative complications. The median OS for this cohort was 14.4 months (range, 0.6-145.0 months) with median follow-up time of 15.5 months. Conclusion: In oligometastatic spinal disease patients with good functional status, corpectomy for decompression of neural elements, deformity correction, and spinal stabilization is associated with improvements in pain and functional outcomes without overwhelming morbidity.

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Section: Complicationscontrasting

confidence: 64%

Survival and Neurological Outcomes Following Corpectomy for Spinal Metastatic Disease: A Single Institutional Experience

Chowdhury,

Teferi,

Lee

et al. 2024

Preprint

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“…Patients with spinal instability and limited life expectancy may undergo percutaneous fixation without fusion. Silva and colleagues conducted a multicenter retrospective study that observed low implant failure rate in short and medium term without fusion [31]. Percutaneous screws may at times be placed with chemotherapeutic agents in attempt to reduce tumor size prior to resection.…”

Section: Percutaneous Stabilizationmentioning

confidence: 99%

Minimally Invasive Treatment of Spinal Metastasis

Mong¹,

Fahim²

2022

Minimally Invasive Spine Surgery - Advances and Innovations

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Advancements in the treatment of systemic cancer have improved life expectancy in cancer patients and consequently the incidence of spinal metastasis. Traditionally, open spinal approaches combined with cEBRT (conventional external beam radiation therapy) allowed for local tumor control as well as stabilization and decompression of the spine and neural elements, but these larger operations can be fraught with one complications and delayed healing as well as additional morbidity. Recently, minimally invasive spine techniques are becoming increasingly popular in the treatment of spinal metastasis for many reasons, including smaller incisions with less perioperative complications and potential for expedited time to radiation therapy. These techniques include kyphoplasty with radiofrequency ablation, percutaneous stabilization, laminectomy, and epidural tumor resection through tubular retractors, as well as minimally invasive corpectomy. These techniques combined with highly conformal stereotactic radiosurgery have led to the advent of separation surgery, which allows for decompression of neural elements while creating space between neural elements and the tumor so adequate radiation may be delivered, improving local tumor control. The versatility of these minimally invasive techniques has significantly improved the modern management of metastatic disease of the spine by protecting and restoring the patient’s quality of life while allowing them to quickly resume radiation and systemic treatment.

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“…Nevertheless, only in recent years, the use of minimally invasive spinal surgery (MISS) in SM patients has increased. Currently in Literature there is no evidence that indicates the absolute superiority of one treatment over the other ( 10 ). Therefore, the aim of the present systematic review and meta-analysis was to evaluate PPSF versus OPIF approaches in treatment of SM patients.…”

Section: Introductionmentioning

confidence: 99%

Posterior Percutaneous Pedicle Screws Fixation Versus Open Surgical Instrumented Fusion for Thoraco-Lumbar Spinal Metastases Palliative Management: A Systematic Review and Meta-analysis

et al. 2022

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BackgroundSurgical palliative treatment of spinal metastases (SM) could influence the quality of life (QoL) in cancer patients, since the spine represents the most common site of secondary bony localization. Traditional open posterior instrumented fusion (OPIF) and Percutaneous pedicle screw fixation (PPSF) became the main surgical treatment alternatives for SM, but in Literature there is no evidence that describes the absolute superiority of one treatment over the other.Materials and MethodsThis is a systematic review and meta-analysis of comparative studies on PPSF versus OPIF in patients with SM, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The outcomes of interest were: complications, blood loss, infections, mortality, pain and also the Quality of Life (QoL).ResultsThere were a total of 8 studies with 448 patients included in the meta-analyses. Postoperative complications were more frequent in OPIF (odds ratio of 0.48. 95% CI, 0.27 to 0.83; p= 0.01), PPFS was associated with blood loss (odds ratio -585.70. 95% IC, -848.28 to -323.13.69; p< 0.0001) and a mean hospital stay (odds ratio -3.77. 95% IC, -5.92 to -1.61; p= 0.0006) decrease. The rate of infections was minor in PPFS (odds ratio of 0.31. 95% CI, 0.12 to 0.81; p= 0.02) whereas the occurrence of reinterventions (0.76. 95% CI, 0.25 to 2.27; p= 0.62) and the mortality rate was similar in both groups (odds ratio of 0.79. 95% CI, 0.40 to 1.58; p= 0.51). Finally, we also evaluated pre and post-operative VAS and the meta-analysis suggested that both techniques have a similar effect on pain.Discussion and ConclusionThe PPSF treatment is related with less complications, a lower rate of infections, a reduction in intraoperative blood loss and a shorter hospital stay compared to the OPIF treatment. However, further randomized clinical trials could confirm the results of this meta-analysis and provide a superior quality of scientific evidence.

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Low Implant Failure Rate of Percutaneous Fixation for Spinal Metastases: A Multicenter Retrospective Study

Cited by 4 publications

References 29 publications

Survival and Neurological Outcomes Following Corpectomy for Spinal Metastatic Disease: A Single Institutional Experience

Survival and Neurological Outcomes Following Corpectomy for Spinal Metastatic Disease: A Single Institutional Experience

Minimally Invasive Treatment of Spinal Metastasis

Posterior Percutaneous Pedicle Screws Fixation Versus Open Surgical Instrumented Fusion for Thoraco-Lumbar Spinal Metastases Palliative Management: A Systematic Review and Meta-analysis

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