Clinical Results of Minimally Invasive Spine Stabilization for Spinal Metastases

Orthopedics ◽  
2017 ◽  
Vol 40 (4) ◽  
pp. e693-e698 ◽  
Author(s):  
Hiroshi Uei ◽  
Yasuaki Tokuhashi ◽  
Masashi Oshima ◽  
Masafumi Maseda ◽  
Koji Matsumoto ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Metastases ◽  
Clinical Results ◽  
Spine Stabilization ◽  
Minimally Invasive Spine ◽  
Minimally Invasive Spine Stabilization

scholarly journals Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization: A single-center retrospective study

2020 ◽  
Author(s):  
Yukako Ishida ◽  
Hideki Shigematsu ◽  
Shinji Tsukamoto ◽  
Yasuhiko Morimoto ◽  
Eiichiro Iwata ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Tumor Board ◽  
Spine Stabilization ◽  
Minimally Invasive Spine ◽  
Minimally Invasive Spine Stabilization

Abstract Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with minimally invasive spine stabilization (MISt). We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, ambulation status, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses. Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. We noted good functional prognosis in patients capable of ambulation within seven days and in patients who could survive longer than three months after the surgery. Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.

scholarly journals Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization

2020 ◽  
Author(s):  
Yukako Ishida ◽  
Hideki Shigematsu ◽  
Shinji Tsukamoto ◽  
Yasuhiko Morimoto ◽  
Eiichiro Iwata ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Tumor Board ◽  
Spine Stabilization ◽  
Before And After ◽  
Minimally Invasive Spine ◽  
Minimally Invasive Spine Stabilization

Abstract Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabilitation with minimally invasive spine stabilization (MISt) effectively improves ADL.Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with MISt. We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses.Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. Neurological deficiency was improved to or maintained at Frankel’s grade E in 16 patients, remained unchanged in 6 patients (in grades B, C, D), and worsened in 5 patients. BI score comparisons before and after surgery in all patients showed statistically significant increments (p < 0.05). On further analysis, we noted good functional prognosis in patients capable of ambulation within seven days (p < 0.05) and in patients who could survive longer than three months after the surgery (p < 0.05).Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.

scholarly journals Safety and Efficacy of All-In-One Percutaneous Pedicle Screw System

2021 ◽  
pp. 219256822110114
Author(s):  
Atsushi Kojima ◽  
Takato Aihara ◽  
Makoto Urushibara ◽  
Kenji Hatakeyama ◽  
Tomonori Sodeyama
Keyword(s):  
Pedicle Screw ◽  
Conventional Method ◽  
Surgical Time ◽  
Computed Tomography Images ◽  
Spine Stabilization ◽  
Percutaneous Pedicle Screw ◽  
Minimally Invasive Spine ◽  
Conventional Methods ◽  
Speed And Accuracy ◽  
Minimally Invasive Spine Stabilization

Study Design: Retrospective study of the prospectively collected outcomes data. Objective: The indications for PPS placement during minimally invasive spine stabilization (MISt) procedures have increased in recent years. To the best of our knowledge, no studies have documented the outcomes of PPS insertion using the all-in-one PPS system. This study compared the conventional methods and the use of all-in-one percutaneous pedicle screw (PPS) system with respect to the speed and accuracy of PPS placement. We also determined the advantages associated with the use of the all-in-one PPS system. Methods: We evaluated 54 patients who underwent PPS insertion using the conventional method and the all-in-one PPS system during MISt procedures. We also assessed the number of implanted PPSs, the time taken to implant PPSs, and the accuracy of PPS placement based on postoperative computed tomography images. Results: A total of 254 PPSs were inserted (126 using the conventional method and 128 using the all-in-one PPS system). The PPS insertion time with the all-in-one PPS system (mean, 25.3 ± 9.1 s) was significantly shorter than that using the conventional method (mean, 63.1 ± 13.0 s; P < 0.01). With respect to the accuracy of PPS insertion, ≥ 2 mm pedicle breach was noted in one case each in both groups. Conclusions: PPS placement using the all-in-one PPS system is as safe as conventional methods and has the potential to save the surgical time of MISt procedures.

scholarly journals Clinical Results of Minimally Invasive Spine Stabilization for the Management of Metastatic Spinal Tumors Based on the Epidural Spinal Cord Compression Scale

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Hiroshi Uei ◽  
Yasuaki Tokuhashi ◽  
Masafumi Maseda ◽  
Masahiro Nakahashi ◽  
Hirokatsu Sawada ◽  
...  
Keyword(s):  
Survival Time ◽  
Barthel Index ◽  
Clinical Results ◽  
Cord Compression ◽  
Postoperative Survival ◽  
Spinal Tumors ◽  
Neurological Improvement ◽  
Spine Stabilization ◽  
Group A ◽  
Minimally Invasive Spine

Purpose. Minimally invasive spine stabilization (MISt) using percutaneous pedicle screws plays a significant role in palliative surgery for metastatic spinal tumors. However, few studies have investigated surgical outcomes based on the epidural spinal cord compression scale (ESCCS). The purpose of this study was to examine outcomes of metastatic spinal tumors as evaluated by ESCCS in patients treated by MISt. Methods. The subjects were 56 patients who underwent MISt for metastatic spinal tumors, including 34 patients with ESCCS 2 or milder (group A) and 22 patients with ESCCS 3 (group B). We analyzed baseline characteristics, perioperative factors and clinical results such as postoperative survival time, neurological outcomes, Barthel Index for activities of daily living (ADL), visual analogue scale (VAS), and the rate of discharge to home. Results. The baseline age (P=0.07), tumor diagnosis (P=0.23), spinal level of compression (P=0.35), American Spinal Injury Association classification (P=0.49), revised Tokuhashi score (P=0.92), spinal instability neoplastic score (P=0.28), VAS (P=0.35), Barthel Index (P=0.07), American Society of Anesthesiologists physical status classification (P=0.76), and type of surgery (P=0.40) did not differ significantly between the two groups. The median postoperative survival time did not differ significantly between the groups (12.0 versus 15.0 months, P=0.60). Neurological improvement by at least 1 grade or maintenance of grade E was favorable in group A. Patients in group A had less posterior decompression (P=0.006), a higher rate of chemotherapy (P=0.009), a higher postoperative Barthel Index (P=0.04), and a higher rate of discharge to home (P=0.01) and no patients died in the hospital (P=0.004). Conclusions. No significant difference was noted in the postoperative survival time between the 2 groups. Patients in the ESCCS 2 or milder group had favorable neurological improvement, higher rates of chemotherapy, better postoperative ADL, and the higher rate of discharge to home.

scholarly journals Ten-Step Minimally Invasive Spine Lumbar Decompression and Dural Repair Through Tubular Retractors

2017 ◽  
Vol 13 (2) ◽  
pp. 232-245 ◽  
Author(s):  
Mohamed Abdelatif Boukebir ◽  
Connor David Berlin ◽  
Rodrigo Navarro-Ramirez ◽  
Tim Heiland ◽  
Karsten Schöller ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Synovial Cyst ◽  
Clinical Results ◽  
Complication Management ◽  
Lumbar Degenerative Disease ◽  
Dural Repair ◽  
Microsurgical Techniques ◽  
Minimally Invasive Spine

Abstract BACKGROUND: Minimally invasive spine (MIS) surgery utilizing tubular retractors has become an increasingly popular approach for decompression in the lumbar spine. However, a better understanding of appropriate indications, efficacious surgical techniques, limitations, and complication management is required to effectively teach the procedure and to facilitate the learning curve. OBJECTIVE: To describe our experience and recommendations regarding tubular surgery for lumbar disc herniations, foraminal compression with unilateral radiculopathy, lumbar spinal stenosis, synovial cysts, and dural repair. METHODS: We reviewed our experience between 2008 and 2014 to develop a step-by-step description of the surgical techniques and complication management, including dural repair through tubes, for the 4 lumbar pathologies of highest frequency. We provide additional supplementary videos for dural tear repair, laminotomy for bilateral decompression, and synovial cyst resection. RESULTS: Our overview and complementary materials document the key technical details to maximize the success of the 4 MIS surgical techniques. The review of our experience in 331 patients reveals technical feasibility as well as satisfying clinical results, with no postoperative complications associated with cerebrospinal fluid leaks, 1 infection, and 17 instances (5.1%) of delayed fusion. CONCLUSION: MIS surgery through tubular retractors is a safe and effective alternative to traditional open or microsurgical techniques for the treatment of lumbar degenerative disease. Adherence to strict microsurgical techniques will allow the surgeon to effectively address bilateral pathology while preserving stability and minimizing complications.

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