SynthesisSpine2016
When Less Is More: The indications for MIS Techniques and Separation Surgery in Metastatic Spine Disease.
Synthesis in Spine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The role of minimally invasive surgery within a multidisciplinary approach for patients with metastatic spine disease over a decade: A systematic review.Neuro-oncology · 2024Pooled it
- Sarcopenia in Patients With Spinal Metastasis: A Systematic Review and Meta-Analysis of Retrospective Cohort Studies.Frontiers in oncology · 2022Pooled it
- Spinal metastases: perioperative and oncological outcomes after separation surgery versus expanded anterior column resection: a retrospective cohort study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- The transformative role of SBRT in the management of spinal metastases.Nature reviews. Clinical oncology · 2026Review
- Article
- Using Endoscopic Approaches in the Surgical Management of Spinal Metastatic Disease.Journal of clinical medicine · 2026Review
- The Radiologists' Guide to Spinal Separation Surgery: What Does the Surgeon Want to Know?Diseases (Basel, Switzerland) · 2025Review
- Maximal feasible resection versus hybrid therapy in spinal metastases: an updated narrative review.World journal of surgical oncology · 2025Review
- Extended length of stay in open versus minimally invasive surgery with robotic-assisted sub-analysis for spinal nerve sheath tumor resection: a nationwide analysis.Scientific reports · 2025Article
- Integrated management of metastatic spinal tumors: current status and future directions.Medical oncology (Northwood, London, England) · 2025Review
- Combined Rigid-Flexible Multibody Analysis Reveals Reduced Pedicle Screw Loads in Short-Segment Fixation for Decompressed Lumbar Spine Stabilization.Annals of biomedical engineering · 2025Article
- Current Concepts in the Management and Treatment of Spinal Metastases-A Systematic Literature Review.Cancers · 2025Review
- Hybrid Therapy with SBRT Target-Tailored Tumor Resection for High-Grade Metastatic Epidural Spinal Cord Compression (MESCC): Illustrative Case.Journal of clinical medicine · 2025Article
- Early versus late construct failure in spine metastatic disease: implications for surgical strategy and oncologic outcome.Journal of neuro-oncology · 2025Article
- What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?Global spine journal · 2025Article
- Spinal metastases at the thoracolumbar junction - Influencing factors for surgical decision-making according to a multicentric registry.Brain & spine · 2025Article
- Article
- Implant and construct decision-making in metastatic spine tumour surgery: a review of current concepts with a decision-making algorithm.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Review
- A new era in the management of spinal metastasis.Frontiers in oncology · 2024Review
- The Utility of 'Minimal Access and Separation Surgery' in the Management of Metastatic Spine Disease.Global spine journal · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
STUDY
designSystematic review.
objectiveThe aim of this study was to review the techniques, indications, and outcomes of minimally invasive surgery (MIS) and separation surgery with subsequent radiosurgery in the treatment of patients with metastatic spine disease. SUMMARY OF BACKGROUND DATA: The utilization of MIS techniques in patients with spine metastases is a growing area within spinal oncology. Separation surgery represents a novel paradigm where radiosurgery provides long-term control after tumor is surgically separated from the neural elements.
methodsPubMed, Embase, and CINAHL databases were systematically queried for literature reporting MIS techniques or separation surgery in patients with metastatic spine disease. PRISMA guidelines were followed.
resultsOf the initial 983 articles found, 29 met inclusion criteria. Twenty-five articles discussed MIS techniques and were grouped according to the primary objective: percutaneous stabilization (8), tubular retractors (4), mini-open approach (8), and thoracoscopy/endoscopy (5). The remaining 4 studies reported separation surgery. Indications were similar across all studies and included patients with instability, refractory pain, or neurologic compromise. Intraoperative variables, outcomes, and complications were similar in MIS studies compared to traditional approaches, and some MIS studies showed a statistically significant improvement in outcomes. Studies of mini-open techniques had the strongest evidence for superiority.
conclusionsLow-quality evidence currently exists for MIS techniques and separation surgery in the treatment of metastatic spine disease. Given the early promising results, the next iteration of research should include higher-quality studies with sufficient power, and will be able to provide higher-level evidence on the outcomes of MIS approaches and separation surgery. LEVEL OF EVIDENCE: N/A.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.