Minimally Invasive Percutaneous Fixation Techniques for Metastatic Spinal Disease

Rao, Prashanth J.; Thayaparan, Ganesha K.; Fairhall, Jacob; Mobbs, Ralph J.

doi:10.1111/os.12114

Cited by 53 publications

(31 citation statements)

References 35 publications

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“…[81] For palliative treatment of spinal metastases, the increasing use of minimally invasive techniques of tumor resection and decompression of neurologic elements have resulted in improved recovery with minimal morbidity and mortality. [82]…”

Section: 4 Therapeutic Management Of Cibpmentioning

confidence: 99%

Bone Pain and Muscle Weakness in Cancer Patients

Milgrom

Lad

Koniaris

et al. 2017

Curr Osteoporos Rep

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Purpose of review In this article we will discuss the current understanding of bone pain and muscle weakness in cancer patients. We will describe the underlying physiology and mechanisms of cancer-induced bone pain (CIBP) and cancier-induced muscle wasting (CIMW), as well as current methods of diagnosis and treatment. We will discuss future therapies and research directions to help patients with these problems. Recent Findings There are several pharmacologic therapies that are currenly in pre-clinical and clinical testing that appear to be promising adjuncts to current CIBP and CIMW therapies. Such therapies include resiniferitoxin, which is a targeted inhibitor of nociptive nerve fibers, and selective androgen receptor modulators, which show promise in increasing lean mass. Summary CIBP and CIMW are a significant causes of morbidity in affected patients. Current management is mostly palliative; however, targeted therapies are poised to revolutionize how these problems are treated.

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Section: 4 Therapeutic Management Of Cibpmentioning

confidence: 99%

Bone Pain and Muscle Weakness in Cancer Patients

Milgrom

Lad

Koniaris

et al. 2017

Curr Osteoporos Rep

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“…Twenty-five articles pertained to MIS surgical techniques and are summarized in Supplemental Digital Content, Table 1, http://links.lww.com/BRS/B215. 8,9,22,24–28 Four articles reported outcomes after separation surgery and are summarized in Supplemental Digital Content, Table 2, http://links.lww.com/BRS/B215.…”

Section: Resultsmentioning

confidence: 99%

When Less Is More

Zuckerman

Laufer

Sahgal

et al. 2016

Spine

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Study Design Systematic review. Objective The aim of this study was to review the techniques, indications, and outcomes of minimally invasive surgery (MIS) and separation surgery with subsequent radiosurgery in the treatment of patients with metastatic spine disease. Summary of Background Data The utilization of MIS techniques in patients with spine metastases is a growing area within spinal oncology. Separation surgery represents a novel paradigm where radiosurgery provides long-term control after tumor is surgically separated from the neural elements. Methods PubMed, Embase, and CINAHL databases were systematically queried for literature reporting MIS techniques or separation surgery in patients with metastatic spine disease. PRISMA guidelines were followed. Results Of the initial 983 articles found, 29 met inclusion criteria. Twenty-five articles discussed MIS techniques and were grouped according to the primary objective: percutaneous stabilization (8), tubular retractors (4), mini-open approach (8), and thoracoscopy/endoscopy (5). The remaining 4 studies reported separation surgery. Indications were similar across all studies and included patients with instability, refractory pain, or neurologic compromise. Intraoperative variables, outcomes, and complications were similar in MIS studies compared to traditional approaches, and some MIS studies showed a statistically significant improvement in outcomes. Studies of mini-open techniques had the strongest evidence for superiority. Conclusions Low-quality evidence currently exists for MIS techniques and separation surgery in the treatment of metastatic spine disease. Given the early promising results, the next iteration of research should include higher-quality studies with sufficient power, and will be able to provide higher-level evidence on the outcomes of MIS approaches and separation surgery.

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“…Considering postoperative pain relief and better neurological function could improve the quality of life, we offered palliative surgery for this patient group. Instead of D-only surgery, minimal invasive surgery such as vertebroplasty, kyphoplasty, and percutaneous techniques could be considered as palliative surgery for metastatic spine tumors [16,17]. Decompression plus instrumentation with PSS and DþPSSþR were both suitable options for patients with the 3-to 6-month life expectancy.…”

Section: Current Answers To the Questionsmentioning

confidence: 99%