ArticleSurgical neurology international2022
Percutaneous fixation for the treatment of metastatic spinal disease provides effective symptom palliation with low rates of hardware failure.
Article in Surgical neurology international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe incidence of survival from metastatic spinal disease (MSD) continues to rise. However, open surgery for MSD is associated with significant perioperative morbidity, while minimally invasive percutaneous pedicle screw fixation (MIPPSF) offers reduced tissue trauma, less blood loss, and a reduction in complications. Lytic bone disease plus perioperative radiation further increase risk for instrument failure, especially in long construct MIPPSF. Here, we compared 6 short construct and 14 long construct outcomes for MIPPSF performed in MSD patients, including multiple myeloma (MM).
methodsFor 20 patients undergoing MIPPSF for MSD, we evaluated disease type, location, the extent of surgery, outcomes, and survival rates. Statistical comparisons were performed between long-segment construct and short-segment construct patients utilizing Kaplan-Meier survival curves, Mann-Whitney U, and Chi-squared tests.
resultsNo instrument failure and comparable symptomatic relief were observed for both short and long MIPPSF constructs. However, long construct patients experienced; a higher incidence of postoperative complications, including screw loosening, but exhibited longer overall survivals (likely related to underlying type of MSD, with MM patients making up the largest portion of long construct patients).
conclusionLong construct MIPPSF in MSD did not have increased risk of construct failure and offered effective symptomatic relief, including for MM patients, without introducing a greater risk construct instability.
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