title: Minimally Invasive Spine Metastatic Tumor Resection and Stabilization: New Technology Yield Improved Outcome.
abstract: Spinal metastases compressing the spinal cord are a medical emergency and should be operated on if possible; however, patients' medical condition is often poor and surgical complications are common. Minimizing surgical extant, operative time, and blood loss can potentially reduce postoperative complications. This is a retrospective study describing the patients operated on in our department utilizing a minimally invasive surgery (MIS) approach to decompress and instrument the spine from November 2013 to November 2014. Five patients were operated on for thoracic or lumbar metastases. In all cases a unilateral decompression with expandable tubular retractor was followed by instrumentation of one level above and below the index level and additional screw at the index level contralateral to the decompression side. Cannulated fenestrated screws were used (Longitude FNS) and cement was injected to increase pullout resistance. Mean operative time was 134 minutes and estimated blood loss was minimal in all cases. Improvement was noticeable in neurological status, function, and pain scores. No complications were observed. Technological improvements in spinal instruments facilitate shorter and safer surgeries in oncologic patient population and thus reduce the complication rate. These technologies improve patients' quality of life and enable the treatment of patients with comorbidities.
authors.affiliation: Spine Surgery Unit, Department of Neurosurgery, Sheba Medical Center, 52621 Ramat-Gan, Israel ; Talpiot Medical Leadership Program, Sheba Medical Center, 52621 Ramat-Gan, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Harel
authors.affiliation: Spine Surgery Unit, Department of Neurosurgery, Sheba Medical Center, 52621 Ramat-Gan, Israel.
authors.forename: Omer
authors.initials: O
authors.lastname: Doron
authors.affiliation: Spine Surgery Unit, Department of Neurosurgery, Sheba Medical Center, 52621 Ramat-Gan, Israel.
authors.forename: Nachshon
authors.initials: N
authors.lastname: Knoller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008161:Lumbosacral Region / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome