The Spine Clinic of Los Angeles, Affiliate of the University of Southern California, The Hospital of the Good Samaritan, 1245 Wilshire Ave, #717, Los Angeles, CA 90017, USA.
J Neurooncol. 2012 May;107(3):443-55. doi: 10.1007/s11060-011-0755-6. Epub 2011 Nov 18.
Over the past decade, the development and refinement of minimally invasive spine surgery techniques has lead to procedures with the potential to minimize iatrogenic and post-operative sequelae that may occur during the surgical treatment of various pathologies. In a similar manner, parallel advances in other current treatment technologies have led to the development of other minimally invasive treatments of spinal malignancies. These advances include percutaneous techniques for vertebral reconstruction, including vertebroplasty and kyphoplasty, the development of safe and effective spinal radiosurgery, and minimal-access spinal surgical procedures that allow surgeons to safely decompress and reconstruct the anterior spinal column. The advent of these new techniques has given modern practitioners treatment options in situations where they previously were limited by the potentially significant morbidities of the available techniques. Here, the authors discuss the application of current minimally invasive technologies in the treatment of malignancies of the thoracic spine, focusing on vertebral kyphoplasty, spinal radiosurgery, and minimally invasive spinal decompression techniques. The author's describe how these emerging treatment options are significantly expanding the options open to clinicians in the treatment of thoracic spinal column malignancies. Specific illustrative case examples are provided. The development of these techniques has the potential to improve clinical outcomes, limit surgical morbidity, and also improve the safety and efficiency of treatment pathways.
在过去的十年中,微创脊柱手术技术的发展和完善使得手术治疗各种疾病时可能发生的医源性和术后后遗症最小化成为可能。以类似的方式,其他当前治疗技术的平行进步也导致了脊柱恶性肿瘤的其他微创治疗方法的发展。这些进展包括用于椎体重建的经皮技术,包括椎体成形术和后凸成形术,安全有效的脊柱放射外科的发展,以及允许外科医生安全减压和重建前脊柱柱的微创脊柱手术程序。这些新技术的出现为现代从业者提供了治疗选择,在以前,由于现有技术可能存在显著的发病率,他们的治疗选择受到限制。在这里,作者讨论了当前微创技术在治疗胸段脊柱恶性肿瘤中的应用,重点介绍了椎体后凸成形术、脊柱放射外科和微创脊柱减压技术。作者描述了这些新的治疗选择如何显著扩大临床医生治疗胸段脊柱恶性肿瘤的选择范围。提供了具体的说明性案例示例。这些技术的发展有可能改善临床结果、限制手术发病率,并提高治疗途径的安全性和效率。