Minimally Invasive Transpedicular Vertebrectomy for Metastatic Disease to the Thoracic Spine

Deutsch, Harel; Boco, Tibor; Lobel, Jeffery

doi:10.1097/bsd.0b013e31805fea01

Cited by 60 publications

(33 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were 3 prospective cohort trials 32,33,38 and 11 retrospective case series. 4,5,[8][9][10]12,13,18,20,30,34 Class I evidence reporting on the use of PTAs was not available from any of the selected articles.…”

Section: Transpedicular Corpectomymentioning

confidence: 99%

“…32 Seven of the retrospective studies reported RRs of 14%, 10 11.1%, 5 8%, 4 4.3%, 9 3.2%, 8 and 0%. 12,18 Pain palliation outcomes were reported in 11 of the 14 studies. In all 3 prospective studies, the outcome measured was pain relief (100% 32,38 and 96% 33 ).…”

mentioning

confidence: 99%

“…Two of the prospective studies reported outcomes: Street et al noted that 75% of patients were alive at 6 months, 32 and Wang et al noted an overall median survival of 7.7 months. 33 Seven of the 11 retrospective studies reported survival outcomes as overall median survival time (11.3 months, 9 9.75 months, 4 8.9 months, 10 8.8 months 8 ), survival at the 12-month follow-up (43%, 30 37.5% 12 ), and survival at 6 months (88.9%). 5 Only 9 of the 14 studies reported RRs.…”

mentioning

confidence: 99%

“…Authors in all 14 studies reported performing a PTA based on the location of the tumor and the surgeon's familiarity with the approach and reconstructive options. 4,5,[8][9][10]12,13,18,20,30,[32][33][34]38 A posterior transpedicular approach with instrumentation was used in 7 studies to stabilize the spine. 4,5,10,18,20,30,33 Deutsch et al reported that a PTA was also used over an anterior approach owing to age, comorbidities, and limited life expectancies.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Posterior approaches for symptomatic metastatic spinal cord compression

Molina

Goodwin

Abu-Bonsrah

et al. 2016

FOC

View full text Add to dashboard Cite

Surgical interventions for spinal metastasis are commonly performed for mechanical stabilization, pain relief, preservation of neurological function, and local tumor reduction. Although multiple surgical approaches can be used for the treatment of metastatic spinal lesions, posterior approaches are commonly performed. In this study, the role of posterior surgical procedures in the treatment of spinal metastases was reviewed, including posterior laminectomy with and without instrumentation for stabilization, transpedicular corpectomy, and costotransversectomy. A review of the literature from 1980 to 2015 was performed using Medline, as was a review of the bibliographies of articles meeting preset inclusion criteria, to identify studies on the role of these posterior approaches among adults with spinal metastasis. Thirty-four articles were ultimately analyzed, including 1 randomized controlled trial, 6 prospective cohort studies, and 27 retrospective case reports and/or series. Some of the reviewed articles had Level II evidence indicating that laminectomy with stabilization can be recommended for improvement in neurological outcome and reduction of pain in selected patients. However, the use of laminectomy alone should be carefully considered. Additionally, transpedicular corpectomy and costotransversectomy can be recommended with the expectation of improving neurological outcomes and reducing pain in properly selected patients with spinal metastases. With improvements in the treatment paradigms for patients with spinal metastasis, as well as survival, surgical therapy will continue to play an important role in the management of spinal metastasis. While this review presents a window into determining the utility of posterior approaches, future prospective studies will provide essential data to better define the roles of the various options now available to surgeons in treating spinal metastases.

show abstract

Section: Transpedicular Corpectomymentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Posterior approaches for symptomatic metastatic spinal cord compression

Molina

Goodwin

Abu-Bonsrah

et al. 2016

FOC

View full text Add to dashboard Cite

show abstract

“…Several different surgical procedures are performed for the treatment of metastatic spine tumors; they include combined anterior-posterior vertebrectomy, multisegment vertebral resection, and spinal instrumentation and fusion [38,[122][123][124]. The overall morbidity of these procedures ranges from 14.3% to 36% [39][40][41]125].…”

Section: Oncological Spine and Sacral Surgerymentioning

confidence: 99%

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

Cata

Gottumukkala

2012

ISRN Anesthesiology

View full text Add to dashboard Cite

Patients with solid malignancies who were not candidates for tumor resections in the past are now presenting for extensive oncological resections. Cancer patients are at risk for thromboembolic complications due to an underlying hypercoagulable state; however, some patients may have an increased risk for bleeding due to the effects of chemotherapy, the administration of anticoagulant drugs, tumor-related fibrinolysis, tumor location, tumor vascularity, and extent of disease. A common potential complication of all complex oncological surgeries is massive intra-and postoperative hemorrhage and the subsequent risk for massive blood transfusion. This can be anticipated or unexpected. Several surgical and anesthesia interventions including preoperative tumor embolization, major vessel occlusion, hemodynamic manipulation, and perioperative antifibrinolytic therapy have been used to prevent or control blood loss with varying success. The exact incidence of massive blood transfusion in oncological surgery is largely unknown and/or underreported. The current literature mostly consists of purely descriptive observational studies. Thus, recommendation regarding specific perioperative intervention cannot be made at this point, and more research is warranted.

show abstract