Minimal-invasive stabilization and circumferential spinal cord decompression in metastatic epidural spinal cord compression (MESCC)

Abstract

Surgery with instrumentation to the spine has been shown to provide excellent pain relief, stabilization and quality of life in patients with spinal metastasis [1, 4, 12, 13, 15]. Surgery may also offer superior outcomes to other treatments, such as radiation in cases of acute spinal cord compression and neurological deficits [7, 11]. In comparison to degenerative spinal disorders [5], there is little data on the use of minimally invasive surgery (MIS) as an alternative to open approaches for spinal metastatic surgery [9]. The benefits of MIS in spinal surgery compared to open approaches include reduction in muscular trauma, blood loss, cost and hospital stay [3, 6, 10, 14]. Here we present a surgical technique of posterior percutaneous instrumentation with minimal-invasive circumferential spinal cord decompression and subsequent thoracoscopically reconstruction of the anterior vertebral column with an expandable titanium cage.