Minimally Invasive Spinal Surgery in Spinal Metastasis Patients: A Case Series in Chulabhorn Hospital

Abstract

Background: Minimally invasive surgeryis becoming more widely used for spinal metastases because it reduces muscle injuries, blood loss and length of hospital stay, as well as post-operative complications. Objective: The purpose of the present study is to report the outcome of minimally invasive spinal surgery by percutaneous pedicular screw fixation with and without decompression in vertebral metastasis patients. Study design: Retrospective study. Materials and Methods: Seventeen patients who were diagnosed with spinal metastasis underwent MIS in Chulabhorn Hospital from August 2016 to December 2018. The authors retrospectively reviewed baseline patient characteristics, perioperative and post-operative outcome, Tomita score, Modified Tokuhashi score, Visual Analog Scale Pain Score and Frankel classification. Results: The average Tomita score was 7.05±2.16 and Modified Tokuhashi score was 8.17±2.6. The average surgical time was 196.70±97.01 minute (254±56.45 min with decompression and 90.67±53.74 min without decompression, p=0.004). The average volume of blood loss was 728±824 ml (1,059+848 ml with decompression and 123.33+233 ml without decompression, p=0.032) The survival rate was 5.87+6.03 months. The pain score decreased significantly after surgery from 9.25+0.93 to 1.56+1.75, including radiating leg pain, which decreased from 5.31+3.22 to 0.75+1.29. Conclusion: Minimally invasive spinal surgery is a treatment option that significantly reduces pain in patients with spinal metastasis. Less blood loss and shorter operative time were observed in minimally invasive spinal surgery alone compared to the group with decompression. Keywords: Percutaneous pedicular screw, Spinal metastasis, Minimally invasive spine surgery