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Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis
STUDY DESIGN: Prospective cohort study. PURPOSE: To report the outcome of 50 patients with spinal metastases treated with minimally invasive stabilization (MISt) using fluoroscopic guided percutaneous pedicle screws with/without minimally invasive decompression. OVERVIEW OF LITERATURE: The advent of...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Spine Surgery
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764548/ https://www.ncbi.nlm.nih.gov/pubmed/26949465 http://dx.doi.org/10.4184/asj.2016.10.1.99 |
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author | Kwan, Mun Keong Lee, Chee Kean Chan, Chris Yin Wei |
author_facet | Kwan, Mun Keong Lee, Chee Kean Chan, Chris Yin Wei |
author_sort | Kwan, Mun Keong |
collection | PubMed |
description | STUDY DESIGN: Prospective cohort study. PURPOSE: To report the outcome of 50 patients with spinal metastases treated with minimally invasive stabilization (MISt) using fluoroscopic guided percutaneous pedicle screws with/without minimally invasive decompression. OVERVIEW OF LITERATURE: The advent of minimally invasive percutaneous pedicle screw stabilization system has revolutionized the treatment of spinal metastasis. METHODS: Between 2008 and 2013, 50 cases of spinal metastasis with pathological fracture(s) with/without neurology deficit were treated by MISt at our institution. The patients were assessed by Tomita score, pain score, operation time, blood loss, neurological recovery, time to ambulation and survival. RESULTS: The mean Tomita score was 6.3±2.4. Thirty seven patients (74.0%) required minimally invasive decompression in addition to MISt. The mean operating time was 2.3±0.5 hours for MISt alone and 3.4±1.2 hours for MISt with decompression. Mean blood loss for MISt alone and MISt with decompression was 0.4±0.2 L and 1.7±0.9 L, respectively. MISt provided a statistically significant reduction in visual analog scale pain score with mean preoperative score of 7.9±1.4 that was significantly decreased to 2.5±1.2 postoperatively (p=0.000). For patients with neurological deficit, 70% displayed improvement of one Frankel grade and 5% had an improvement of 2 Frankel grades. No patient was bed-ridden postoperatively, with the average time to ambulation of 3.4±1.8 days. The mean overall survival time was 11.3 months (range, 2–51 months). Those with a Tomita score <8 survived significantly longer than those a Tomita score ≥8 with a mean survival of 14.1±12.5 months and 6.8±4.9 months, respectively (p=0.019). There were no surgical complications, except one case of implant failure. CONCLUSIONS: MISt is an acceptable treatment option for spinal metastatic patients, providing good relief of instability back pain with no major complications. |
format | Online Article Text |
id | pubmed-4764548 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Korean Society of Spine Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-47645482016-03-06 Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis Kwan, Mun Keong Lee, Chee Kean Chan, Chris Yin Wei Asian Spine J Clinical Study STUDY DESIGN: Prospective cohort study. PURPOSE: To report the outcome of 50 patients with spinal metastases treated with minimally invasive stabilization (MISt) using fluoroscopic guided percutaneous pedicle screws with/without minimally invasive decompression. OVERVIEW OF LITERATURE: The advent of minimally invasive percutaneous pedicle screw stabilization system has revolutionized the treatment of spinal metastasis. METHODS: Between 2008 and 2013, 50 cases of spinal metastasis with pathological fracture(s) with/without neurology deficit were treated by MISt at our institution. The patients were assessed by Tomita score, pain score, operation time, blood loss, neurological recovery, time to ambulation and survival. RESULTS: The mean Tomita score was 6.3±2.4. Thirty seven patients (74.0%) required minimally invasive decompression in addition to MISt. The mean operating time was 2.3±0.5 hours for MISt alone and 3.4±1.2 hours for MISt with decompression. Mean blood loss for MISt alone and MISt with decompression was 0.4±0.2 L and 1.7±0.9 L, respectively. MISt provided a statistically significant reduction in visual analog scale pain score with mean preoperative score of 7.9±1.4 that was significantly decreased to 2.5±1.2 postoperatively (p=0.000). For patients with neurological deficit, 70% displayed improvement of one Frankel grade and 5% had an improvement of 2 Frankel grades. No patient was bed-ridden postoperatively, with the average time to ambulation of 3.4±1.8 days. The mean overall survival time was 11.3 months (range, 2–51 months). Those with a Tomita score <8 survived significantly longer than those a Tomita score ≥8 with a mean survival of 14.1±12.5 months and 6.8±4.9 months, respectively (p=0.019). There were no surgical complications, except one case of implant failure. CONCLUSIONS: MISt is an acceptable treatment option for spinal metastatic patients, providing good relief of instability back pain with no major complications. Korean Society of Spine Surgery 2016-02 2016-02-16 /pmc/articles/PMC4764548/ /pubmed/26949465 http://dx.doi.org/10.4184/asj.2016.10.1.99 Text en Copyright © 2016 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Kwan, Mun Keong Lee, Chee Kean Chan, Chris Yin Wei Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis |
title | Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis |
title_full | Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis |
title_fullStr | Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis |
title_full_unstemmed | Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis |
title_short | Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis |
title_sort | minimally invasive spinal stabilization using fluoroscopic-guided percutaneous screws as a form of palliative surgery in patients with spinal metastasis |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764548/ https://www.ncbi.nlm.nih.gov/pubmed/26949465 http://dx.doi.org/10.4184/asj.2016.10.1.99 |
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