Percutaneous Treatment of the Spinal Metastases

Abstract

Introduction The spinal column is the most frequent site of bone metastasis, and between 30 % and 70 % of patients with cancer will have evidence of spinal metastasis at autopsy. The majority of metastasis occurs in the thoracic spine (70 %) followed by the lumbar (20 %) and cervical region (10 %). The surgical treatment of the vertebral metastases remains a real challenge in spine surgeons. Recent advances in surgical techniques allow a less aggressive approach of the patient with better results in terms of decreasing pain, improvement of the quality of life. We must avoid the overtreatment of terminally ill patients, some patients may survive for several years and benefit from surgery. Materials and methods The surgical techniques that we used from August 2006 to October 2011 were the coablation associated with vertebroplasty and percutaneous osteosynthesis. Very important were the operating room set up and the surgical technique. In our clinic, in the last 5 years, 115 patients were treated, 76 patients (94 vertebrae) with vertebroplasty and ablation. We used the percutaneous osteosynthesis in 39 patients aged between 42 and 88 years (mean 65 years). Results In both types of treatments, the postoperative elapsed were regular with early mobilization and regression of pain. Discussion The diagnosis and treatment of spinal metastases require multidisciplinary review. The optimal treatment depends from a balance between the morbidity of the surgical procedure, the estimated survival time, and the overall quality of life. Conclusions We believe that these minimally invasive techniques are certainly a viable alternative to ''open'' traditional spine surgery and can help in order to reduce the pain and to restore the stability.