Management of Spinal Metastasis by Minimally Invasive Surgical Techniques: Surgical Principles and Indications—A Literature Review

Abstract

Background: Spinal metastasis is becoming more frequent. This raises the topics of pain and neurological complications, which worsen the functional and survival prognosis of oncological population patients. Surgical treatment must be as complete as possible in order to decompress and stabilize without delaying the management of the oncological disease. Minimally invasive spine surgical techniques inflict less damage on the musculocutaneous plan than opened ones. Methods: Different minimally invasive techniques are proposed in this paper for the management of spinal metastasis. We used our experience, developed degenerative and traumatic pathologies, and referred to many authors, establishing a narrative review of our local practice. Results: Forty-eight articles were selected, and these allowed us to describe the different techniques: percutaneous methods such as vertebro/kyphoplasty, osteosynthesis, mini-open surgery, or that through a posterior or anterior approach. Also, some studies detail the contribution of new technologies, such as intraoperative CT scan and robotic assistance. Conclusions: It seems essential to offer a lasting solution to a spinal problem, such as in the form of pain relief, stabilization, and decompression. Our department has embraced a multidisciplinary and multidimensional approach to MISS, incorporating cutting-edge technologies and evidence-based practices.

Rethinking Strategies for Multi-Metastatic Patients: A Comprehensive Retrospective Analysis on Open Posterior Fusion Versus Percutaneous Osteosynthesis in the Treatment of Vertebral Metastases

“…Our findings aligned with those of previous studies that suggested minimally invasive spine surgery (MISS) offered significant advantages over traditional open procedures. For example, Meyer et al (2023) reported a substantial reduction in surgical site infections with MISS compared to open surgery in a large cohort of patients undergoing lumbar decompression and fusion [ 23 ]. Similarly, Conti et al (2019) emphasized the improved quality of life and reduced perioperative morbidity associated with MISS in patients with metastatic spinal cord compression [ 24 ].…”

Mexican Multicenter Experience of Metastatic Spinal Disease

“…This statistical difference is given by a sub-classification in which thoracolumbar tumors were divided into thoracic, lumbar, and thoracolumbar, with the totality of these resulting in 40%, unlike previously reported literature. According to the literature, up to 30% corresponded to lesions in segments that were not contiguous at the time of metastasis diagnosis and may or may not be symptomatic [ 28 - 31 ]. Although we cannot define what caused this variability, it can be suspected that with a later diagnosis of a primary solid tumor, there is a greater probability that metastasis detected at the vertebral level will be present in two or more non-contiguous sites.…”