Alshareef Mohammed Abdul, Klapthor Gibson, Lowe Stephen R, Barley Jessica, Cachia David, Frankel Bruce M
Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, United States.
Department of Radiology, Wake Forest University, Winston-Salem, North Carolina, United States.
Surg Neurol Int. 2020 Dec 22;11:462. doi: 10.25259/SNI_815_2020. eCollection 2020.
Metastatic epidural spinal cord compression (MESCC) is a debilitating sequela of cancer. Here, we evaluated various subtypes of posterior-only minimally invasive spinal (MIS) procedures utilized to address different cancers.
Within this retrospective review, we analyzed the treatment of thoracolumbar MESCC treated with three MIS techniques: decompression and fusion (Subgroup A), partial corpectomy (Subgroup B), and full corpectomy (Subgroup C).
There were 51 patients included in the study; they averaged 58.7 years of age, and 51% were females. Most tumors were in the thoracic spine (51%). The average preoperative Frankel grade was D (62.7%); 69% (35) improved postoperatively. The patients were divided as follows: subgroup A (15 patients = 29.4%), B (19 patients = 37.3%), and C (17 patients = 33.3%). The length of hospitalization was similar (~5.4 days) for all groups. The overall complication rate was 31%, while blood loss was lower in Subgroups A and B versus C.
Different MIS surgical techniques were utilized in patients with thoracic and/or lumbar MESCC. Interestingly, clinical outcomes were similar between MIS subgroups, in this study, with a trend toward higher complications and greater blood loss associated with those undergoing more aggressive MIS procedures (e.g., full corpectomy and fusion).
转移性硬膜外脊髓压迫症（MESCC）是癌症导致的一种使人衰弱的后遗症。在此，我们评估了用于治疗不同癌症的各种仅后路微创脊柱（MIS）手术亚型。
在这项回顾性研究中，我们分析了采用三种MIS技术治疗胸腰椎MESCC的情况：减压融合术（A组）、部分椎体切除术（B组）和全椎体切除术（C组）。
该研究共纳入51例患者；他们的平均年龄为58.7岁，51%为女性。大多数肿瘤位于胸椎（51%）。术前平均Frankel分级为D级（62.7%）；69%（35例）术后病情改善。患者分组如下：A组（15例患者 = 29.4%）、B组（19例患者 = 37.3%）和C组（17例患者 = 33.3%）。所有组的住院时间相似（约5.4天）。总体并发症发生率为31%，A组和B组的失血量低于C组。
胸段和/或腰段MESCC患者采用了不同的MIS手术技术。有趣的是，在本研究中，MIS亚组之间的临床结果相似，趋势是更积极的MIS手术（如全椎体切除术和融合术）相关的并发症更高、失血量更大。
