title: Minimally invasive decompression and stabilization for the management of thoracolumbar spine metastasis.
abstract: OBJECTIVE
  Spinal metastasis with spinal cord involvement is a frequent complication in cancer patients. As the spinal compression frequently occurs ventrally, performing a simple posterior laminectomy alone is generally ineffective and dangerous. Many aggressive surgical strategies have been developed to improve outcomes for patients with metastatic spine disease. These strategies are associated with high morbidity and complication rates, especially in patients with numerous neoplasm-associated comorbidities, which can limit their indication in patients with a limited life expectancy. The authors performed a prospective evaluation of minimally invasive decompression and stabilization for the palliative management of symptomatic thoracolumbar spine metastasis.
  
  
  METHODS
  Ten patients with metastasis to the thoracolumbar spine and neurological compromise underwent minimally invasive transpedicular vertebrectomy and spinal cord decompression through a tubular expandable retractor. Percutaneous stabilization was also systematically performed to ensure spinal stability.
  
  
  RESULTS
  No complications during the procedure were reported. The mean operative duration was 170 minutes and the mean estimated blood loss was 400 ml. The postoperative course of all patients was uneventful, with the exception of 1 benign urinary tract infection. Eight patients (80%) improved at least 1 Frankel grade.
  
  
  CONCLUSIONS
  Minimally invasive treatment of thoracolumbar spine metastasis is a safe and effective palliative option in patients with limited life expectancy, to limit morbidity and preserve quality of life.
authors.affiliation: Department of Neurosurgery, Lille University Hospital, Rue Emile Laine, Lille, France. fahed.zairi@gmail.com
authors.forename: Fahed
authors.initials: F
authors.lastname: Zairi
authors.forename: Ala
authors.initials: A
authors.lastname: Arikat
authors.forename: Mohamed
authors.initials: M
authors.lastname: Allaoui
authors.forename: Paulo
authors.initials: P
authors.lastname: Marinho
authors.forename: Richard
authors.initials: R
authors.lastname: Assaker
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D059146:Metastasectomy / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*