Review Article

A Systematic Review of the Current Role of Minimally Invasive Spine Surgery in the Management of Metastatic Spine Disease

Table 2

Minimal access spine surgery outcomes. MOT: Mean operating time; LOS: Length of stay; NI: Neurological improvement rate; PA: Pain alleviation rate; CR: Complications rate; MBL: Mean blood loss, SVR: 2-year survival rate.

StudyDesign and procedureOutcome results

Mühlbauer et al. [27], 2000Retrospective case series ( ) of patients undergoing lumbar corpectomy and anterior reconstruction via MASS in the setting of osteoporotic or malignancy-related compression fracturesMOT: 6 hours
NI: All patients experienced neurological improvement and were ambulatory at followup (6 mo to 1 yr)
PA: All patients experienced pain relief. 40% of patients did not utilize analgesics at 1-year followup
CR: Segmental vessel nick via a high-speed drill. Bleeding was adequately controlled
MBL: 1120 mL

Huang et al. [23], 2006Retrospective analysis ( ) comparing MASS ( ) to standard thoracotomy (ST) ( ) in the management of thoracic spinal metastasisMOT: MASS = 179 mins versus ST = 180 mins;
% Requiring 2-day ICU stay: MASS = 6.9% versus ST = 88%,
NI: Reacquisition of ambulation postoperatively; MASS = 70.8% versus ST = 69.2%,
SVR: MASS = 27.4 mo versus ST = 24.8 mo,
CR: MASS = 24% versus ST = 29%
MBL: MASS = 1,100 mL versus ST = 1,162 mL,

Deutsch et al. [28], 2008Retrospective case series ( ) of patients undergoing MASS posterolateral vertebrectomy and decompression for the management of thoracic spinal metastasisMOT: 2.2 hours
LOS: 4 days
NI: 62.5% of patients
PA: 62.5% of patients
CRs: none
MBL: 227 mL

Kan and Schmidt [29], 2008Retrospective case series ( ) of patients undergoing MASS anterior corpectomy and decompression for the management of thoracic spinal metastasisMOT: 4.3 hours
LOS: 6.25
NI: All patients experienced neurological improvement
PA: All patients experienced pain alleviation
CR: none
MBL: 610 mL

Payer and Sottas [30], 2008Retrospective case series ( ) analyzing operative outcomes of MASS conducted with the SynFrame (Stratec Medical, Obendorf, Switzerland) table mounted retractor in the setting of thoracic metastatic spine diseaseMOT: 188 mins
NI: All patients neurologically intact, at presentation remained intact and 91% of patients with preoperative deficit experienced neurological improvement
CR: 18% (2/11; one dural tear and one superficial wound infection)
MBL: 711 mL

Taghva et al. [31], 2010Case report of a man undergoing vertebrectomy and expandable cage reconstruction for the management of metastatic lung adenocarcinoma localized to the thoracic spineMOT: 7 hours
LOS: 5 days
NI: Patient experienced myelopathy relief and was ambulatory on postoperative day 1
PA: at 9-month followup, patient remained back pain-free with no use of analgesic medications
CR: none
MBL: 1200 mL