The role of minimally invasive surgery within a multidisciplinary approach for patients with metastatic spine disease over a decade: A systematic review

Alexander J. Schupper, Shrey Patel, Jeremy M. Steinberger, Isabelle M. Germano

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Metastatic spine disease (MSD) occurs commonly in cancer patients causing pain, spinal instability, devastating neurological compromise, and decreased quality of life. Oncological patients are often medically complex and frail, precluding them form invasive procedures.To address this issue, minimally invasive spinal surgery (MISS) techniques are desirable.The aim of this study is to review published peer-reviewed literature and ongoing clinical trials to provide current state of the art. Methods. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, assessing MISS in MSD patients for the period 2013–2023. Innovations under development were assessed by querying and reviewing data from currently enrolling U.S. registered clinical trials. Results. From 3,696 articles, 50 studies on 3,196 patients focused on spinal oncology MISS.The most commonly reported techniques were vertebral augmentation (VA), percutaneous spinal instrumentation, and radiofrequency ablation (RFA). Surgical instrumentation/stabilization techniques were reported in 10/50 articles for a total of 410 patients. The majority of studies focused on pain as a primary outcome measure, with 28/50 studies reporting a significant improvement in pain following intervention. In the United States, 13 therapeutic trials are currently recruiting MSD patients.Their main focus includes radiosurgery,VA and/or RFA, and laser interstitial thermal therapy. Conclusions. Due to their medical complexity and increased fragility, MSD patients may benefit from minimally invasive approaches. These strategies are effective at mitigating pain and preventing neurological deterioration, while providing other advantages including ease to start/resume systemic/radiotherapy treatment(s).

Original languageEnglish
Pages (from-to)417-428
Number of pages12
JournalNeuro-Oncology
Volume26
Issue number3
DOIs
StatePublished - 1 Mar 2024

Keywords

  • cement augmentation
  • instrumented fusion
  • minimally invasive spine surgery
  • quality of life
  • spinal oncology

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