Department of Neurosurgery, Neurocenter of South Switzerland, EOC, Lugano, Switzerland.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Neurol Sci. 2023 Feb;44(2):519-528. doi: 10.1007/s10072-022-06432-x. Epub 2022 Oct 1.
In the last years, laser interstitial thermal therapy (LITT) has started to be used also in neurosurgical setting. Its efficacy for intracranial pathologies, namely, tumors and epilepsy, has been widely demonstrated. However, the literature evidences about the use of LITT for spinal lesions are recent, and it is still a topic of discussion regarding its efficacy. Here, the authors sought to present a systematic review of the literature investigating the utility of LITT for spinal lesions.
Using PubMed, Scopus, and the Cochrane Library, the authors performed a systematic review of the literature focused on the use of spinal laser interstitial thermal therapy (sLITT). Included in the search were randomized controlled trials, cohort studies, and clinical series. Two independent reviewers conducted the study appraisal, data abstraction, and quality assessments of the studies.
Out of the initial 134 studies, 6 met the inclusion criteria for the systematic review, resulting in a total of 206 patients. All the patients have been treated with sLITT for compressive spinal metastases. Most of the lesions were thoracic (88.8%). All the studies reported an effective local control of the disease with a reduction of epidural compression at 30 days. Complication rate was 12.6%, but most of them were transient conditions, and only 3.4% patients needed a revision surgery.
sLITT is safe and provides effective local control for epidural compression from metastases, particularly in the thoracic spine. The authors propose considering sLITT as an alternative to open surgery in selected patients with spinal metastases.
近年来，激光间质热疗（LITT）已开始应用于神经外科领域。其治疗颅内病变（如肿瘤和癫痫）的疗效已得到广泛证实。然而，关于 LITT 治疗脊柱病变的文献证据相对较新，其疗效仍存在争议。本文作者旨在对 LITT 治疗脊柱病变的相关文献进行系统回顾。
作者通过 PubMed、Scopus 和 Cochrane Library 系统检索了有关 sLITT 治疗脊柱病变的文献。纳入标准为随机对照试验、队列研究和临床系列研究。两名独立的审查员对研究进行评估、数据提取和质量评估。
最初的 134 项研究中，有 6 项符合系统评价的纳入标准，共纳入 206 例患者。所有患者均接受 sLITT 治疗压迫性脊柱转移瘤。大多数病变位于胸椎（88.8%）。所有研究均报道了疾病的有效局部控制，30 天时硬膜外压迫减轻。并发症发生率为 12.6%，但大多数为短暂性，只有 3.4%的患者需要再次手术。
sLITT 治疗脊柱转移瘤引起的硬膜外压迫是安全且有效的。作者建议在选择的脊柱转移瘤患者中，将 sLITT 作为开放手术的替代方法。
