When Would Minimally Invasive Spinal Surgery Not Be Preferable for Metastatic Spine Disease?

IF 1.7 Q2 SURGERY

International Journal of Spine Surgery Pub Date : 2024-11-15 DOI:10.14444/8658

Si Jian Hui, Jiong Hao Tan, Sahil Athia, Priyambada Kumar, Renick Lee, Shahid Ali, Seok Woo Kim, Naresh Kumar

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引用次数: 0

Abstract

Background: Metastatic spine tumor surgery (MSTS) is an important treatment modality of metastatic spinal disease (MSD). Open spine surgery (OSS) was previously the gold standard of treatment till the early 2010s. However, advancements in MSTS in recent years have led to the advent of minimally invasive spinal surgery (MISS) techniques for the treatment of MSD. The clear benefits of MISS have resulted in a current paradigm shift toward today's gold standard of MISS and early adjuvant radiotherapy in treating MSD patients. Nonetheless, despite improvements in surgical techniques and the rise of literature supporting MISS for MSD, there are still certain situations whereby MISS is not desirable or even suitable. There has also yet to be any literature describing the considerations of not using MISS in MSD in today's clinical context.

Methods: A narrative review was conducted for this manuscript. All studies related to OSS and MISS in MSTS were included.

Results: A total of 54 studies were included in this review. These studies discussed various advantages of MISS for MSD in today's clinical context, including the patient profile, location of vertebrae involved with metastasis requiring treatment, tumor characteristics, as well as equipment availability.

Conclusion: This study establishes situations in which MISS can be less applicable despite the advantages it may confer over traditional OSS. MSTS should be individualized, depending on the experience of the surgeon. OSS is a time-tested approach that still holds weight in MSTS and should be readily utilized depending on the clinical situation.

Level of evidence: 4:

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何时微创脊柱手术不适合转移性脊柱疾病？

背景：转移性脊柱肿瘤手术（MSTS）是转移性脊柱疾病（MSD）的一种重要治疗方式。直到 2010 年代初，开放脊柱手术（OSS）一直是治疗的金标准。然而，近年来脊柱微创手术（MSTS）的进步导致了用于治疗 MSD 的微创脊柱手术（MISS）技术的出现。微创脊柱手术的明显优势导致了目前治疗 MSD 患者的范式向微创脊柱手术和早期辅助放疗这一黄金标准转变。然而，尽管手术技术有所改进，支持 MISS 治疗 MSD 的文献也在增加，但在某些情况下，MISS 仍然不可取，甚至不适合。在当今的临床背景下，也还没有任何文献描述在 MSD 中不使用 MISS 的考虑因素：本手稿进行了叙述性综述。方法：为撰写本稿件，我们进行了叙述性综述，纳入了所有与开放源码软件和 MISS 在 MSTS 中的应用相关的研究：结果：本综述共纳入 54 项研究。这些研究讨论了 MISS 在当今临床环境下用于 MSD 的各种优势，包括患者情况、需要治疗的转移椎体位置、肿瘤特征以及设备可用性：本研究确定了在哪些情况下 MISS 的适用性较低，尽管它可能比传统的 OSS 更具优势。MSTS 应根据外科医生的经验进行个性化设计。OSS是一种久经考验的方法，在MSTS中仍具有重要意义，应根据临床情况随时使用：4:

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Spine Surgery Medicine-Surgery

CiteScore

3.10

自引率

0.00%

发文量

162

期刊介绍： The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.