Minimally invasive thoracoscopic approach for anterior decompression and stabilization of metastatic spine disease.
OBJECTIVE
The choices available in the management of metastatic spine disease are complex, and the role of surgical therapy is increasing. Recent studies have indicated that patients treated with direct surgical decompression and stabilization before radiation have better functional outcomes than those treated with radiation alone. The most common anterior surgical approach for direct spinal cord decompression and stabilization in the thoracic spine is open thoracotomy; however, thoracotomy for spinal access is associated with morbidity that can be avoided with minimally invasive techniques like thoracoscopy.


METHODS
A minimally invasive thoracoscopic approach was used for the surgical treatment of thoracic and thoracolumbar metastatic spinal cord compression. This technique allows ventral decompression via corpectomy, inter-body reconstruction with expandable cages, and stabilization with an anterolateral plating system designed specifically for minimally invasive implantation. This technique was performed in 5 patients with metastatic disease of the thoracic spine, including the thoracolumbar junction.


RESULTS
All patients had improvement in preoperative symptoms and neurological deficits. No complications occurred in this small series.


CONCLUSIONS
The minimally invasive thoracoscopic approach can be applied to the treatment of thoracic and thoracolumbar metastatic spine disease in an effort to reduce access morbidity. Preliminary results have indicated that adequate decompression, reconstruction, and stabilization can be achieved with this technique.
Kan
Peter
P
Department of Neurosurgery, Clinical Neurosciences Center, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84132, USA.
Schmidt
Meic H
MH
D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D013125:Spinal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*