Comparison of Minimally Invasive Tubular Surgery with Conventional Surgery in the Treatment of Thoracolumbar Metastasis.

Abstract

BackgroundThis study aimed to evaluate the perioperative safety and efficacy of minimally invasive tubular surgery for patients with spinal metastasis.MethodsA total of 161 consecutive patients with spinal metastasis between June 2017 and June 2020 were retrospectively reviewed. A total of 36 patients were included in this study, 14 patients underwent minimally invasive tubular surgery (M), and 22 patients underwent conventional surgery (C). T-test and chi-square tests were used to evaluate demographic and perioperative data differences between the two groups.ResultsBaseline characteristics did not differ significantly between M and C groups except for the SINS (p=0.002) and preoperative Alb (p=0.026). There was no significant difference in operative time and complications between M and C groups (p<0.05). The M group had less mean blood loss than the C group (1275 vs 718mL, p=0.045). Blood transfusion was comparable between the two groups (p<0.05). The mean amount and drainage time were lower than the C group (141 vs 873mL, p<0.001; 3.1 vs 7.0 days, P<0.001). The mean postoperative hospitalization of the M group was 8.8 days, which was lower than the C group (11.3 days, p=0.045). Sub-analysis showed that for patients with hyper-vascular tumor, the M group had less mean amount and time of drainage compared with the C group (p<0.05); for patients with hypo-vascular tumor, the mean blood loss and amount of blood transfusion were also reduced in M group (p<0.05). The mean blood loss and drainage time of patients with hypo-vascular tumors were less than patients with hyper-vascular tumors in the M group (p<0.05).ConclusionIn selected cases, minimally invasive tubular surgery is safe and effective for patients with spinal metastasis. Patients with hypo-vascular tumors were more suitable for this technique with less blood loss, fewer blood transfusions, minor drainage, and shorter postoperative hospitalization.