Endoscopic approaches to metastatic thoracic disease.
Traditional approaches to thoracic metastases and spinal cord compression have been well worked out and validated in the literature. Anterior decompression is clearly superior to laminectomy; vertebrectomy and reconstruction are indicated for sagittal collapse, instability, and pain; and surgical decompression is necessary in cases of bony impingement. The role of endoscopic and minimally invasive techniques in treatment of metastatic disease is evolving. Dr. Lieberman advocates the use of thoracoscopic anterior approaches as the principal application in these patients, whereas Dr. McLain has found that endoscopic assistance has vastly improved his results with posterolateral decompression. The two authors weigh the relative advantages and disadvantages of these approaches for the selected patient with metastatic thoracic disease.
McLain
R F
RF
Section of Spine Surgery, Department of Orthopaedic Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. mclainr@cesmtp.ccf.org
Lieberman
I H
IH
D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D013116:Spinal Cord / Q000601:surgery*; D013117:Spinal Cord Compression / Q000601:surgery*; D013899:Thoracic Neoplasms / Q000556:secondary / Q000601:surgery; D013906:Thoracoscopy