Abstract
Background and Objectives: There have been numerous advances in spine surgery for metastatic spinal tumors, and minimally invasive spine stabilization (MISt) is becoming increasingly popular in Japan. MISt is a minimally invasive fixation procedure that temporarily stabilizes the spine, thereby reducing pain, preventing pathological fractures, and improving activities of daily living at an early stage. MISt may be useful given the recent shift toward outpatient cancer treatment. Materials and Methods: This study enrolled 51 patients with metastatic spinal tumors who underwent surgery using MISt between December 2013 and October 2020. The Spinal Instability Neoplastic Score, an assessment of spinal instability, was used to determine the indication for surgery, and the Epidural Spinal Cord Compression scale was used for additional decompression. Results: The patients comprised 34 men and 17 women, and the mean age at surgery was 68.9 years. The mean postoperative follow-up period was 20.8 months, and 35 of 51 patients (67%) had died by the last survey. The mean operative time was 159.8 min, mean blood loss was 115.7 mL, and mean time to ambulation was 3.2 days. No perioperative complications were observed, although two patients required refixation surgery. Preoperatively, 37 patients (72.5%) were classified as Frankel grade E. There were no cases of postoperative exacerbation, and six patients showed improvement of one or more Frankel grades after surgery. The median duration of patient survival was about 22.0 months. Patients with breast, prostate, renal, and thyroid cancers had a good prognosis, whereas those with gastrointestinal and head and neck cancers had a poor prognosis. Conclusions: MISt can benefit patients who are ineligible for conventional, highly invasive surgery and is also suitable because cancer treatment is increasingly performed on an outpatient basis. Furthermore, choosing the right surgery for the right patient at the right time can significantly affect life expectancy.
Highlights
Cancer treatment has changed drastically over the past decade
We provided multidisciplinary therapeutic intervention for all metastatic spine tumors [6]
For impending spinal instability defined by a spinal instability neoplastic score (SINS) score between 7 and 12, surgery was selected if imaging studies showed vertebral collapse or osteolysis of the posterior wall of the vertebral body or the pedicle of the vertebral arch or if ambulation was impossible because of severe pain
Summary
Cancer treatment has changed drastically over the past decade. Advances in therapies include molecular-targeted drugs, immune checkpoint inhibitors, bone-modifying agents, chemotherapy, and radiotherapy. Multidisciplinary and systemic treatments have started being used These developments have significantly improved life expectancy, and we are living in an era of coexistence with cancer, with shorter hospitalization periods and a shift of treatment to outpatient settings. If ADLs are impaired, patients may not be eligible for chemotherapy or radiotherapy, which may affect their life expectancy [3,4] and hinder the transition of treatment to an outpatient setting. There have been numerous advances in spine surgery for metastatic spinal tumors, and minimally invasive spine stabilization (MISt) is becoming increasingly popular in Japan. Conclusions: MISt can benefit patients who are ineligible for conventional, highly invasive surgery and is suitable because cancer treatment is increasingly performed on an outpatient basis. Choosing the right surgery for the right patient at the right time can significantly affect life expectancy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
