Lengthy-segment percutaneous screw fixation for thoraco-lumbar backbone metastases: a single heart’s expertise.
J Neurosurg Sci. 2017 Aug;61(four):365-370
Authors: Zairi F, Vielliard MH, Bouras A, Karnoub MA, Marinho P, Assaker R
BACKGROUND: The administration of backbone metastases is an growing concern for backbone surgeons. Their therapy is especially palliative with the aim to protect or restore the sufferers’ high quality of life. Many minimally invasive strategies have been launched with the goal to scale back the morbidity related to extra conventional open approaches. We aimed to guage the effectivity of lengthy phase percutaneous pedicle screw stabilization for the therapy of instability related to symptomatic thoracolumbar backbone metastases.
METHODS: On this potential research, we included all sufferers who underwent the percutaneous placement of pedicle screws in our establishment between January 2008 and June 2014, for the palliative therapy of a symptomatic thoracolumbar backbone metastasis. All sufferers had a standard examination. Postoperative radiation remedy was deliberate inside 2 weeks following the stabilization. A scientific and radiological follow-up have been deliberate at Three months, 6 months and 1 12 months. Ache was measured utilizing VAS and useful standing was assessed utilizing the Frankel Grading system. CT scan was carried out earlier than discharge and at every workplace analysis.
RESULTS: Forty-four sufferers have been included. There have been 26 males and 18 ladies, with a imply age of 57.Three years (vary 36-79 years). The imply operative time was 85 minutes (vary 47-124 min), and the estimated blood loss was inferior to 100 mL in all circumstances. The imply size of hospital keep was 5.2 days (vary Three-18 days). All sufferers underwent postoperative radiation remedy inside 2 weeks. Ache was considerably improved from the early postoperative interval (P<Zero.001). Visible Analogic Scale scores decreased from 6.Three (2-10) to three.Zero (Zero-6) at discharge. No affected person worsened his neurological situation postoperatively. One affected person required a revision surgical procedure at Three months attributable to an vital tumor development on the handled stage. Radiological follow-up demonstrated no case of misplacement, breakage or loosening.
CONCLUSIONS: Because the therapy of backbone metastases is basically palliative, minimally invasive strategies needs to be mentioned first to restrict the influence of surgical procedure in important sufferers. Lengthy-segment percutaneous screw fixation adopted by early radiation remedy, seems to be a protected and efficient therapy possibility to make sure stable and sturdy stability, in addition to a great native tumor management.
PMID: 26439452 [PubMed – indexed for MEDLINE]