The efficacy of laser interstitial thermal therapy in the management of spinal metastases: a systematic review of the literature

Cardia, Andrea; Cannizzaro, Delia; Stefini, Roberto; Chibbaro, Salvatore; Ganau, Mario; Zaed, Ismail

doi:10.1007/s10072-022-06432-x

Cited by 4 publications

(1 citation statement)

References 34 publications

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“…One of which was a review of 58 patients who received LITT for posterior fossa lesions, often difficult to access through craniotomy, which found that 84% of patients did not have any tumor progression at the 9.5-month postoperative follow-up [ 13 ]. Another study reviewed 206 patients who received LITT for spinal metastases and reported that all patients had effective local control of the disease with a reduction of epidural compression at 30 days [ 14 ]. These findings are encouraging for neurosurgeons who want to begin using LITT in anatomical structures and regions that have not been previously reported on, such as tumors in the pineal region, as was the case for our team.…”

Section: Discussionmentioning

confidence: 99%

Laser Interstitial Thermal Therapy for the Treatment of a Pineal Region Glioma Through an Infratentorial Approach: A Case Report

Nabulsi¹,

Abouelleil²,

Patra³

et al. 2023

Cureus

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Laser interstitial thermal therapy (LITT) is a minimally invasive surgical option for the treatment of brain tumors introduced in 1983. The innovative technique was welcomed for its ability to access deep-seated supratentorial and posterior cranial fossa lesions. Surgical approaches to pineal region tumors are challenging and require a high degree of precision since the critical vasculature, such as the vein of Galen and precentral vein, in the area pose significant anatomical challenges to operating surgeons. To minimize the risk of damaging this key venous anatomy, an infratentorial approach may be more advantageous. We present a case where LITT was utilized through an infratentorial approach to a pineal region tumor.A 62-year-old male with no significant past medical history presented to his primary care physician complaining of ataxia and headaches for the past four weeks. An MRI was concerning for multicentric glioma within the cerebellar hemispheres, brainstem extending to the middle cerebellar peduncle, upper cervical spinal cord, and pineal region. An enhancing lesion of the midbrain tectum was concerning for a high-grade tumor. We decided to proceed with stereotactic biopsy and magnetic resonance-guided LITT via an infratentorial approach. Supratentorial trajectory planning did not allow for a safe corridor due to the venous anatomy; thus, it was decided to proceed with an infratentorial approach. The patient was positioned prone, had his bone fiducial CT fused with MRI, and the tumor was targeted using robotic guidance (ROSA, Zimmer Biomet, Warsaw, Indiana). Postoperatively, he suffered from transient diplopia due to cranial nerve VI palsy. Additionally, the postoperative MRI revealed a decrease in the size of the enhancing lesion and the hyperintense T2 signal within the brainstem.Open surgical approaches to tumors within the pineal region often pose an anatomic and neurovascular challenge. We describe the safe utilization of a novel, previously unreported infratentorial approach utilizing LITT with promising treatment, morbidity, and efficacy outcomes. A larger series will be necessary to ensure the safety and efficacy of this approach.

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Section: Discussionmentioning

confidence: 99%

Laser Interstitial Thermal Therapy for the Treatment of a Pineal Region Glioma Through an Infratentorial Approach: A Case Report

Nabulsi¹,

Abouelleil²,

Patra³

et al. 2023

Cureus

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Complications following laser interstitial thermal therapy: a review

McGrath,

Frain,

Hey

et al. 2025

Neurochirurgie

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IgA multiple myeloma-associated mediastinal spinal plasmacytoma presenting as spinal cord compression

Prathivadhi-Bhayankaram,

Marar,

Atiya

et al. 2024

BMJ Case Rep

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Multiple myeloma associated with extramedullary plasmacytoma at initial presentation is rare. We describe a case of a man in his 30s who initially presented with symptoms of spinal cord compression. Further imaging revealed a mediastinal tumour, with a biopsy confirming plasmacytoma. Immunofixation revealed IgA lambda paraprotein. Bone marrow biopsy demonstrated atypical T-cell cytotoxic proliferation and trilineage hypoplasia. The patient was diagnosed with extramedullary plasmacytoma with active IgA multiple myeloma. The patient received mediastinal radiation to the tumour, followed by anti-myeloma therapy. This diagnosis is critical as managing a solitary plasmacytoma drastically differs from an extramedullary plasmacytoma with active multiple myeloma.

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The efficacy of laser interstitial thermal therapy in the management of spinal metastases: a systematic review of the literature

Cited by 4 publications

References 34 publications

Laser Interstitial Thermal Therapy for the Treatment of a Pineal Region Glioma Through an Infratentorial Approach: A Case Report

Laser Interstitial Thermal Therapy for the Treatment of a Pineal Region Glioma Through an Infratentorial Approach: A Case Report

Complications following laser interstitial thermal therapy: a review

IgA multiple myeloma-associated mediastinal spinal plasmacytoma presenting as spinal cord compression

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