Erratum to “Minimally Invasive Surgery without Decompression for Hepatocellular Carcinoma Spinal Metastasis with Epidural Spinal Cord Compression Grade 2” by Jung JM, et al. (J Korean Neurosurg Soc 62 : 467-475, 2019)

Background: Metastatic epidural spinal cord compression (MESCC) is a debilitating sequela of cancer. Here, we evaluated various subtypes of posterior-only minimally invasive spinal (MIS) procedures utilized to address different cancers. Methods: Within this retrospective review, we analyzed the treatment of thoracolumbar MESCC treated with three MIS techniques: decompression and fusion (Subgroup A), partial corpectomy (Subgroup B), and full corpectomy (Subgroup C). Results: There were 51 patients included in the study; they averaged 58.7 years of age, and 51% were females. Most tumors were in the thoracic spine (51%). The average preoperative Frankel grade was D (62.7%); 69% (35) improved postoperatively. The patients were divided as follows: subgroup A (15 patients = 29.4%), B (19 patients = 37.3%), and C (17 patients = 33.3%). The length of hospitalization was similar (~5.4 days) for all groups. The overall complication rate was 31%, while blood loss was lower in Subgroups A and B versus C. Conclusion: Different MIS surgical techniques were utilized in patients with thoracic and/or lumbar MESCC. Interestingly, clinical outcomes were similar between MIS subgroups, in this study, with a trend toward higher complications and greater blood loss associated with those undergoing more aggressive MIS procedures (e.g., full corpectomy and fusion).

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Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis

Journal of Neurosurgery Spine ◽

10.3171/2015.2.spine141185 ◽

2015 ◽

Vol 23 (4) ◽

pp. 400-411 ◽

Cited By ~ 48

Author(s):

Claudio E. Tatsui ◽

R. Jason Stafford ◽

Jing Li ◽

Jonathan N. Sellin ◽

Behrang Amini ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Real Time ◽

Spinal Cord Compression ◽

Spinal Metastasis ◽

Cord Compression ◽

The Mean ◽

Interstitial Thermotherapy

OBJECT High-grade malignant spinal cord compression is commonly managed with a combination of surgery aimed at removing the epidural tumor, followed by spinal stereotactic radiosurgery (SSRS) aimed at local tumor control. The authors here introduce the use of spinal laser interstitial thermotherapy (SLITT) as an alternative to surgery prior to SSRS. METHODS Patients with a high degree of epidural malignant compression due to radioresistant tumors were selected for study. Visual analog scale (VAS) scores for pain and quality of life were obtained before and within 30 and 60 days after treatment. A laser probe was percutaneously placed in the epidural space. Real-time thermal MRI was used to monitor tissue damage in the region of interest. All patients received postoperative SSRS. The maximum thickness of the epidural tumor was measured, and the degree of epidural spinal cord compression (ESCC) was scored in pre- and postprocedure MRI. RESULTS In the 11 patients eligible for study, the mean VAS score for pain decreased from 6.18 in the preoperative period to 4.27 within 30 days and 2.8 within 60 days after the procedure. A similar VAS interrogating the percentage of quality of life demonstrated improvement from 60% preoperatively to 70% within both 30 and 60 days after treatment. Imaging follow-up 2 months after the procedure demonstrated a significant reduction in the mean thickness of the epidural tumor from 8.82 mm (95% CI 7.38–10.25) before treatment to 6.36 mm (95% CI 4.65–8.07) after SLITT and SSRS (p = 0.0001). The median preoperative ESCC Grade 2 was scored as 4, which was significantly higher than the score of 2 for Grade 1b (p = 0.04) on imaging follow-up 2 months after the procedure. CONCLUTIONS The authors present the first report on an innovative minimally invasive alternative to surgery in the management of spinal metastasis. In their early experience, SLITT has provided local control with low morbidity and improvement in both pain and the quality of life of patients.

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Minimally Invasive Circumferential Spinal Decompression and Stabilization for Symptomatic Metastatic Spine Tumor

Neurosurgery ◽

10.1227/01.neu.0000365270.23815.b1 ◽

2010 ◽

Vol 66 (3) ◽

pp. E620-E622 ◽

Cited By ~ 22

Author(s):

Alexander Taghva ◽

Khan W. Li ◽

John C. Liu ◽

Ziya L. Gokaslan ◽

Patrick C. Hsieh

Keyword(s):

Spinal Cord ◽

Minimally Invasive ◽

Spinal Cord Compression ◽

Surgical Techniques ◽

Cord Compression ◽

Pedicle Screw Fixation ◽

Lower Extremity Weakness ◽

Hardware Failure ◽

Minimally Invasive Surgical ◽

Potential Benefits

Abstract OBJECTIVE Metastatic epidural spinal cord compression is a potentially devastating complication of cancer and is estimated to occur in 5% to 14% of all cancer patients. It is best treated surgically. Minimally invasive spine surgery has the potential benefits of decreased surgical approach–related morbidity, blood loss, hospital stay, and time to mobilization. CLINICAL PRESENTATION A 36-year-old man presented with worsening back pain and lower extremity weakness. Workup revealed metastatic adenocarcinoma of the lung with spinal cord compression at T4 and T5. INTERVENTION AND TECHNIQUE T4 and T5 vertebrectomy with expandable cage placement and T1–T8 pedicle screw fixation and fusion were performed using minimally invasive surgical techniques. RESULT The patient improved neurologically and was ambulatory on postoperative day 1. At the 9-month follow-up point, he remained neurologically intact and pain free, and there was no evidence of hardware failure. CONCLUSION Minimally invasive surgical circumferential decompression may be a viable option for the treatment of metastatic epidural spinal cord compression.

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Relationship Between Paralysis and the Epidural Spinal Cord Compression Scale in Spinal Metastasis

Orthopedics ◽

10.3928/01477447-20200812-09 ◽

2020 ◽

Vol 43 (6) ◽

pp. e567-e573

Author(s):

Hiroshi Uei ◽

Yasuaki Tokuhashi ◽

Masafumi Maseda

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Spinal Metastasis ◽

Cord Compression

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1048 – Is Minimally-Invasive Surgery an Added-Value for Patients with Hepatocellular Carcinoma and Portal Vein Hypertension Undergoing Liver Resection? Results of an International Multi-Institutional Analysis

Gastroenterology ◽

10.1016/s0016-5085(19)40627-6 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-1431

Author(s):

Fabio Bagante ◽

Andrea Ruzzenente ◽

Eliza W.W. Beal ◽

Simone Conci ◽

Katiuscha Merath ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Minimally Invasive Surgery ◽

Liver Resection ◽

Minimally Invasive ◽

Portal Vein ◽

Invasive Surgery ◽

Institutional Analysis ◽

Added Value ◽

Portal Vein Hypertension

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Non-fusion palliative spine surgery without reconstruction is safe and effective in spinal metastasis patients: retrospective study

Scientific Reports ◽

10.1038/s41598-021-97056-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Siravich Suvithayasiri ◽

Borriwat Santipas ◽

Sirichai Wilartratsami ◽

Monchai Ruangchainikom ◽

Panya Luksanapruksa

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Survival Data ◽

Spinal Metastasis ◽

Cord Compression ◽

Neurological Deficits ◽

Survival Duration ◽

Related Complication ◽

The Mean ◽

Anterior Reconstruction

AbstractConsidering the shorter life expectancy and poorer prognosis of metastatic epidural spinal cord compression patients, anterior reconstruction and fusion may be unnecessary. This study aimed to investigate the outcomes of palliative surgery for metastatic epidural spinal cord compression with neurological deficit among patients who underwent posterior decompression and instrumentation without fusion or anterior reconstruction. This single-center retrospective review included all patients aged > 18 years with thoracic or lumbar spinal metastasis who were surgically treated for metastatic spinal cord compression without fusion or anterior reconstruction at the Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during July 2015 to December 2017. Data from preoperation to the 1-year follow-up, including demographic and clinical data, Frankel classification, pain scores, complication, revision surgery, health-related quality-of-life scores, and survival data, were collected and analyzed. A total of 30 patients were included. The mean age was 59.83 ± 11.73 years, and 20 (66.7%) patients were female. The mean operative time was 208.17 ± 58.41 min. At least one Frankel grade improvement was reported in 53.33% of patients. The pain visual analog scale, the EuroQOL five-dimension five-level utility score, and the Oswestry Disability Index were all significantly improved at a minimum of 3 months after surgery. No intraoperative mortality or instrument-related complication was reported. The mean survival duration was 11.4 ± 8.97 months. Palliative non-fusion surgery without anterior reconstruction may be considered as a preferable choice for treating spinal metastasis patients with spinal cord compression with neurological deficits.

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