Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors

Abstract

Patients with metastatic spinal disease are affected by disabling pain. The treatment of spinal metastases is focused on pain reduction and improvement in quality of life. Until recently, many patients with metastatic spinal disease did not qualify as surgical candidates due to the risks of surgery and length of recovery period. However, recent advances in minimally invasive surgery such as kyphoplasty and vertebroplasty allow patients to safely undergo surgery for pain relief with a short recovery period.The studies reviewed here suggest that vertebral augmentation is successful in reducing pain and disability scores in patients with painful metastases and multiple myeloma and are a safe modality to provide lasting pain relief. As the use of kyphoplasty and vertebroplasty for treatment of vertebral metastases is becoming more common, new combinations of cement augmentation with other techniques such as percutaneous pedicle screws and radiofrequency ablation are being explored. The implementation of kyphoplasty and vertebroplasty, in conjunction with other minimally invasive surgical techniques as well as nonsurgical modalities, may lead to the best palliative management of cancer patients with spinal metastases and help them ultimately achieve a better quality of life.

Unusual Metastasis of Papillary Thyroid Cancer to the Thoracic Spine: A Case Report, New Surgical Management Proposal, and Review of the Literature

“…The short recovery time for this technique allows for a prompt resumption of systemic therapy. [ 10 ]…”

Percutaneous transforaminal endoscopic decompression in the treatment of spinal metastases

“…Due to the short life expectancy of these afflicted patients, treatment protocols for this disease are often palliative rather than curative. [ 1 – 3 ] Although the benefit of aggressive surgeries in managing the pain and neurologic deficits from metastatic spine disease, these treatments are of high risk with low returns, especially the postoperative recovery consumes much of the remainder of life. [ 2 – 5 ] Thus a minimally invasive technique is desired.…”

Image-guided Percutaneous Polymethylmethacrylate-augmented Spondylodesis for Painful Metastasis in the Veteran Population

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