Minimally Invasive Spinal Stabilization Using Fluoroscopic-Guided Percutaneous Screws as a Form of Palliative Surgery in Patients with Spinal Metastasis
Asian Spine Journal
;
: 99-110, 2016.
Article
Dans Anglais
| WPRIM
| ID: wpr-28507
ABSTRACT
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 or =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.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Soins palliatifs
/
Études prospectives
/
Études de cohortes
/
Marche à pied
/
Dorsalgie
/
Décompression
/
Échelle visuelle analogique
/
Fractures spontanées
/
Métastase tumorale
/
Neurologie
Type d'étude:
Etude d'étiologie
/
Etude d'incidence
/
Étude observationnelle
/
Facteurs de risque
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Asian Spine Journal
Année:
2016
Type:
Article
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