PURPOSE: This study was designed to assess the impact of minimally invasive surgery (MIS) for the treatment of patients with metastatic epidural spinal cord compression (MESCC) and vertebral body fracture, in terms of feasibility, clinical improvement, and morbidity. METHODS: Twenty-five consecutive patients with diagnosis of MESCC from solid primary tumors were treated between January 2008 and June 2010 at our institution. All patients, after multidisciplinary assessment, were considered with poor prognosis because of their disease's extension and/or other clinical conditions. Mini-invasive percutaneous surgery was performed in all patients followed by radiotherapy within 2 weeks postoperatively. Clinical outcome was evaluated by modified visual analog scale for pain, Frankel Scale for neurologic deficit, and magnetic resonance imaging or computed tomography scan. RESULTS: Clinical remission of pain was obtained in the vast majority of patients (96%). Improvement of neurological deficit was observed in 22 patients (88%). No major morbidity or perioperative mortality occurred. The average hospital stay was 6 days. Local recurrence occurred in two patients (8%). Median survival was 10 (range, 6-24) months. Overall survival at 1 year was 43%. CONCLUSIONS: For patients with MESCC and body fracture, with limited life expectancy, minimally invasive spinal surgery followed by radiotherapy, is feasible and provides clinical benefit in most of patients, with low morbidity. We believe that a minimally invasive approach can be an alternative surgical method compared with more aggressive or demanding procedures, which in selected patients with metastatic spinal cord compression with poor prognosis could represent overtreatment.
PURPOSE: This study was designed to assess the impact of minimally invasive surgery (MIS) for the treatment of patients with metastatic epidural spinal cord compression (MESCC) and vertebral body fracture, in terms of feasibility, clinical improvement, and morbidity. METHODS: Twenty-five consecutive patients with diagnosis of MESCC from solid primary tumors were treated between January 2008 and June 2010 at our institution. All patients, after multidisciplinary assessment, were considered with poor prognosis because of their disease's extension and/or other clinical conditions. Mini-invasive percutaneous surgery was performed in all patients followed by radiotherapy within 2 weeks postoperatively. Clinical outcome was evaluated by modified visual analog scale for pain, Frankel Scale for neurologic deficit, and magnetic resonance imaging or computed tomography scan. RESULTS: Clinical remission of pain was obtained in the vast majority of patients (96%). Improvement of neurological deficit was observed in 22 patients (88%). No major morbidity or perioperative mortality occurred. The average hospital stay was 6 days. Local recurrence occurred in two patients (8%). Median survival was 10 (range, 6-24) months. Overall survival at 1 year was 43%. CONCLUSIONS: For patients with MESCC and body fracture, with limited life expectancy, minimally invasive spinal surgery followed by radiotherapy, is feasible and provides clinical benefit in most of patients, with low morbidity. We believe that a minimally invasive approach can be an alternative surgical method compared with more aggressive or demanding procedures, which in selected patients with metastatic spinal cord compression with poor prognosis could represent overtreatment.
Authors: Rachit Kumar; Anick Nater; Ahmed Hashmi; Sten Myrehaug; Young Lee; Lijun Ma; Kristin Redmond; Simon S Lo; Eric L Chang; Albert Yee; Charles G Fisher; Michael G Fehlings; Arjun Sahgal Journal: Neurooncol Pract Date: 2015-07-27
Authors: Chia-Lin Tseng; Wietse Eppinga; Raphaele Charest-Morin; Hany Soliman; Sten Myrehaug; Pejman Jabehdar Maralani; Mikki Campbell; Young K Lee; Charles Fisher; Michael G Fehlings; Eric L Chang; Simon S Lo; Arjun Sahgal Journal: Global Spine J Date: 2017-04-06
Authors: Scott L Zuckerman; Ilya Laufer; Arjun Sahgal; Yoshiya J Yamada; Meic H Schmidt; Dean Chou; John H Shin; Naresh Kumar; Daniel M Sciubba Journal: Spine (Phila Pa 1976) Date: 2016-10-15 Impact factor: 3.241