Adjunct and minimally invasive techniques for the diagnosis and treatment of vertebral tumors (original) (raw)
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Minimally Invasive Treatment of Spinal Tumors
Seminars in Spine Surgery, 2011
Minimally invasive access techniques are increasingly applied to patients with spine tumors, eliminating the morbidity of more invasive open procedures in appropriate patients. Minimally invasive treatments include various percutaneous image-guided approaches with radiofrequency ablation, drilling, or intralesional injections of cement, embolic agents, or medications that promote sclerosis or ossification. Intraoperative ablation methods include direct lesional injection of cement and devascularizing options with injection of embolic agents and cryocoagulation. Semin Spine Surg 23:51-59
Minimal invasive approaches in metastatic spinal tumors
Turkish Neurosurgery, 2013
The surgical treatment of spinal metastases is still controversial. Due to developments in diagnostic imaging there has been a great evolution in minimally invasive surgical techniques for the spinal surgery. Most of the patients with spinal metastases are debilitated and under high risk of major surgical morbidity and mortality. Less perioperative pain, less blood loss, less hospitalization time, protection of the spine biomechanics, fast recovery and less morbidity in medically debilitated patients are the advantages of minimally invasive surgical techniques. Radiotherapy, chemotherapy or combining both treatments are the standard treatment options for spinal tumors following surgery. Standard open approaches are not suitable for some patients due to limited life expectancies, high surgical complication rates and decrease in quality of life. Minimal invasive techniques represent major advance in minimizing approach related morbidity in the treatment of spinal tumors. Because of the evolution of minimally invasive surgical techniques for the spinal surgery, minimally invasive techniques are alternative treatment to standard open approaches for the treatment of metastatic spinal tumors. Due to less complication rates there has been a trend toward the minimalization of spine surgery.
Cureus, 2017
Patients with metastatic spinal disease are affected by disabling pain. The treatment of spinal metastases is focused on pain reduction and improvement in quality of life. Until recently, many patients with metastatic spinal disease did not qualify as surgical candidates due to the risks of surgery and length of recovery period. However, recent advances in minimally invasive surgery such as kyphoplasty and vertebroplasty allow patients to safely undergo surgery for pain relief with a short recovery period. The studies reviewed here suggest that vertebral augmentation is successful in reducing pain and disability scores in patients with painful metastases and multiple myeloma and are a safe modality to provide lasting pain relief. As the use of kyphoplasty and vertebroplasty for treatment of vertebral metastases is becoming more common, new combinations of cement augmentation with other techniques such as percutaneous pedicle screws and radiofrequency ablation are being explored. The implementation of kyphoplasty and vertebroplasty, in conjunction with other minimally invasive surgical techniques as well as nonsurgical modalities, may lead to the best palliative management of cancer patients with spinal metastases and help them ultimately achieve a better quality of life.
En Bloc Resection of Primary Spinal Tumors
Seminars in Spine Surgery, 2009
Primary tumors of the spine present an oncologic and technical challenge to obtain a cure. En bloc resection of the lesion allows for complete removal of the tumor with negative margins. This report details this technique along with a discussion of the reconstruction and associated potential complications.
En Bloc Vertebral Resection for Primary and Metastatic Spine Tumors
Coluna/Columna
Objective Primary and secondary spine tumors occur frequently and treating them surgically has gained prominence. The objective of this study was to evaluate the outcomes and complications in a series of patients with primary and secondary vertebral tumors treated by en bloc vertebral resection. Methods A retrospective review of the patients who underwent en bloc vertebral resection between 2004 and 2017 was conducted. Results During the study period, 16 patients underwent en bloc vertebral resection. They were divided into primary tumor and metastatic tumor groups, 11 being primary tumors and 5 metastatic tumors. The average follow-up period was 95 months (3-156 months). The patients were treated by the same surgical team and the analysis was carried out by an independent observer. Conclusion In this case series, the results where comparable to those reported in the literature in terms of complications, survival, recurrence and neurological status. It is a demanding surgical techni...
Management of Vertebral Malignant Tumors: Clinical and Radiographic Study
Journal of Spine, 2014
26 patients underwent decompression-stabilization procedures for their malignant spinal lesions. Fifteen were females and 11 males. Their average age was 60.6 years (range 18-73 years). These patients were classified according to extent of involvement of the spine. One column was involved in 1/26 (3.8%) case, two in 11/26 cases (42.3%) and three in 14/26 cases (53.8%). A posterior approach alone was done in 8/26 (30.8%) patients while a combined anterior and posterior approaches were done in 18/26 (69.2%) cases. A variety of posterior stabilization procedures were used. Out of 24 patients who were able to attend the follow-up 16 (66.7%) were able to walk, five (20.8%) were paraparetic, and 3 patients (12.5%) were paraplegic. Patients with combined approach showed higher percentage of neurologic improvement (62%) while patients with posterior approach showed only 35% improvement in their neurologic status. Accordingly results obtained from direct anterior approaches using corpectomy ...
Surgical Treatment of Metastatic Spinal Tumors
Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 2010
Spinal metastases represent a significant cause of morbidity in patients diagnosed with malignancies. Metastases to the spine can cause severe pain, paralysis, and impairment of activities of daily living. The treatment paradigm for spinal metastases involves a cohesive multidisciplinary approach that allows treatment plans to be made in the context of a patient's overall condition. There have been significant advances in the surgical treatment of spinal metastases that can significantly improve a patient's quality of life. Mt Sinai J Med 77:124-129, 2010. 2010 Mount Sinai School of Medicine Key Words: epidural metastasis, pathological fracture, spinal cord compression, spinal instability, spinal metastasis.