Minimal invasive fixation following with radiotherapy for radiosensitive unstable metastatic spine

Chi, Jia-En; Ho, Chao‐Hung; Chiu, Ping-Yeh; Kao, Fu-Cheng; Tsai, Tsung-Ting; Lai, Po‐Liang; Niu, Chi‐Chien

doi:10.1016/j.bj.2021.08.004

Cited by 4 publications

(9 citation statements)

References 42 publications

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“…Screening by titles and abstracts was performed with subsequent full text reading of the remaining articles. A total of 7 studies met our inclusion criteria and fulfil the purpose of the review ( 13 – 19 ). One of the eligible study was excluded for a short follow up (30 days) ( 20 ).…”

Section: Resultsmentioning

confidence: 99%

“…All the included studies reported intraoperative blood loss, with 195 patients in the PPSF group and 253 in the OPIF group ( 13 – 19 ). The meta-analysis of the data revealed a mean difference of -585.70 (95% IC, -848.28 to -323.13; p< 0.0001), thus suggesting a decreasing odd of complications in the PPSF group compared to OPIF ( Figure 2B ).…”

Section: Resultsmentioning

confidence: 99%

“…The length of hospitalization was reported in 5 of the included papers, with 147 patients in the PPSF group and 202 in the OPIF group ( 13 , 14 , 16 , 18 , 19 ). The meta-analysis of the data revealed a mean difference of -3.77 (95% IC, -5.92 to -1.61; p= 0.0006), thus suggesting a decreasing mean hospital stay in the PPSF group compared to OPIF group ( Figure 2C ).…”

Section: Resultsmentioning

confidence: 99%

“…Six of the included studies reported the occurrence of postoperative infections, with 170 patients in the PPSF group and 228 in the OPIF group ( 13 – 16 , 18 , 19 ). The meta-analysis of these data showed an odds ratio of 0.31 (95% CI, 0.12 to 0.81; p= 0.02), showing a reduced infection rate in the PPSF group compared to the OPIF group ( Figure 2D ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of six studies described mortality, with 142 patients in the PPSF group and 197 in the OPIF group ( 13 , 14 , 16 , 17 , 19 ). The meta-analysis of these data showed an odds ratio of 0.79 (95% CI, 0.40 to 1.58; p= 0.51), demonstrating that both techniques have a similar mortality rate ( Figure 3B ).…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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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An area of greatest vulnerability - Recent advances in kidney injury

Kattner¹

2022

Biomedical Journal

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Effects of Palliative Surgical Treatment for Spinal Metastases on the Patient’s Quality of Life With a Focus on the Segment of the Metastasis: A Prospective Multicenter Study

Segi,

Nakashima,

Ito

et al. 2024

Global Spine Journal

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Study Design Prospective multicenter study. Objectives Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments. Methods We prospectively compared the data of 203 patients with spinal metastases at 2-3 consecutive segments who were divided into the following three groups: cervical, patients with cervical spine lesions; thoracic, patients with upper–middle thoracic spine lesions; and TL/L/S, patients with lesions at the thoracolumbar junction and lumbar and sacral regions. Preoperative and postoperative EuroQol 5-dimension (EQ5D) 5-level were compared. Results All groups exhibited improvement in the Frankel grade, performance status, pain, Barthel index, EQ5D health state utility value (HSUV), and EQ5D visual analog scale (VAS) postoperatively. Although preoperative EQ5D HSUVs did not significantly differ between the groups (cervical, 0.461 ± 0.291; thoracic, 0.321 ± 0.292; and TL/L/S, 0.376 ± 0.272), the thoracic group exhibited significantly lower postoperative EQ5D HSUVs than the other two groups (cervical, 0.653 ± 0.233; thoracic, 0.513 ± 0.252; and TL/L/S, 0.624 ± 0.232). However, postoperative EQ5D VAS was not significantly different between the groups (cervical, 63.4 ± 25.8; thoracic, 54.7 ± 24.5; and TL/L/S, 61.7 ± 21.9). Conclusions Palliative surgery for metastatic spinal tumors provided comparable QOL improvement, irrespective of the spinal segment involved. Patients with upper and middle thoracic spinal metastases had poorer QOL outcomes than those with metastases in other segments; however, sufficient QOL improvement was achieved.

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Minimal invasive fixation following with radiotherapy for radiosensitive unstable metastatic spine

Cited by 4 publications

References 42 publications

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

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

An area of greatest vulnerability - Recent advances in kidney injury

Effects of Palliative Surgical Treatment for Spinal Metastases on the Patient’s Quality of Life With a Focus on the Segment of the Metastasis: A Prospective Multicenter Study

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