Reyes Soto Gervith, Moreno Daniel Vega, Serrano-Murillo Monica, Castillo-Rangel Carlos, Gonzalez-Aguilar Alberto, Meré Gómez José Rodrigo, Garcìa Fuentes Pablo Isaac, Cacho Diaz Bernardo, Ramirez Manuel de Jesus Encarnacion, Nikolenko Vladimir, Cherubin Tshiunza M, Amador Hernández Miguel Agustín, Montemurro Nicola
Neurosurgical Oncology, Mexico's National Institute of Cancer, Tlalpan, MEX.
Neurosurgery, Universidad Nacional Autónoma de México, Coyoacán, MEX.
Cureus. 2024 Sep 30;16(9):e70503. doi: 10.7759/cureus.70503. eCollection 2024 Sep.
Introduction The role of separation surgery in managing symptomatic spinal metastases has been increasing in recent years, and it represents a crucial part of the definitive management of this condition. Methods We report on a series of seven patients treated at the National Cancer Institute in Mexico using minimally invasive approaches to perform transpedicular corpectomy. The goal was to obtain a margin of tumor-free tissue, enabling the completion of oncological treatment with radiotherapy. Results We collected data from six cases. The mean age was 61.2 years. Surgical outcomes were good in 83.3% of patients. Ranging from minimally invasive instrumentations to total or partial corpectomies, these procedures achieved their intended function of generating healthy neural tissue free of tumor. This ensures that the radiation gradient does not affect this tissue. No surgical complications were reported. The objective of these surgeries was to establish a radiotherapy or radiosurgery regimen as soon as possible, thereby improving patients' quality of life (QoL). Conclusions Low-cost transpedicular corpectomy via minimally invasive surgery (MIS) is a safe and effective method that meets the goals of separation surgery. However, prospective studies are needed to directly compare open techniques with minimally invasive methods.
引言 近年来,分离手术在治疗有症状的脊柱转移瘤中的作用不断增加,它是这种疾病最终治疗的关键部分。方法 我们报告了在墨西哥国家癌症研究所治疗的一系列7例患者,采用微创方法进行经椎弓根椎体切除术。目的是获得无肿瘤组织切缘,以便完成放疗的肿瘤治疗。结果 我们收集了6例患者的数据。平均年龄为61.2岁。83.3%的患者手术结果良好。从微创器械操作到全椎体或部分椎体切除术,这些手术实现了产生无肿瘤健康神经组织的预期功能。这确保了放射梯度不会影响该组织。未报告手术并发症。这些手术的目的是尽快建立放疗或放射外科治疗方案,从而改善患者的生活质量(QoL)。结论 通过微创手术(MIS)进行低成本经椎弓根椎体切除术是一种安全有效的方法,符合分离手术的目标。然而,需要进行前瞻性研究以直接比较开放技术与微创方法。