A Retrospective Cohort Study Comparing the Safety and Efficacy of Minimally Invasive Versus Open Surgical Techniques in the Treatment of Spinal Metastases

Tomohiro Hikata, Norihiro Isogai, Yuta Shiono, Haruki Funao, Eijiro Okada, Nobuyuki Fujita, Akio Iwanami, Kota Watanabe, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Ken Ishii

Research output: Contribution to journalArticle

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Abstract

Study Design: A retrospective cohort study. Objective: This study was conducted to assess the invasiveness, efficacy, and safety of minimally invasive spine stabilization (MISt) for metastatic spinal tumor patients with short life expectancy. Summary of Background Data: Conventional open surgery for metastatic spinal tumors has the disadvantages of significant blood loss, potential infection, damage to back muscles, and extended hospital stays. The minimally invasive spine surgery has changed the treatment of metastatic spinal tumors radically and fundamentally. Materials and Methods: We retrospectively reviewed data from 50 consecutive patients registered with the Keio Spine Research Group (KSRG) who underwent posterior palliative surgery for metastatic spinal tumors from January 2009 to June 2015. Of these, 25 patients underwent MISt surgery (M group), and 25 underwent conventional open surgery (C group). The patients were assessed by demographic data, surgical invasiveness, complications, pain improvement, and neurological recovery. Results: The 2 groups did not differ significantly in baseline characteristics. The M group had significantly less blood loss (M, 340.1 mL; C, 714.3 mL; P=0.005), less postoperative drainage (M, 136.0 mL; C, 627.0 mL; P<0.001), lower rates of red blood cell transfusion (M, 3 cases; C, 10 cases; P=0.029), and a shorter postoperative period of bed rest (M, 2.0 d; C, 3.6 d; P<0.001), compared with the C group. The perioperative complication rates were significantly lower (P=0.012) in the M group (3 patients, 12%) than in the C group (11 patients, 44%). Neurological deficits and pain improved significantly and comparably in the 2 groups after surgery. Conclusions: MISt is a less invasive and effective alternative surgery to conventional open surgery for metastatic spinal tumors. MISt should be considered as a valid option for the treatment of metastatic spinal tumor patients with a short life expectancy. Level of Evidence: Level 3.

Original languageEnglish
Pages (from-to)E1082-E1087
JournalClinical Spine Surgery
Volume30
Issue number8
DOIs
Publication statusPublished - 01-01-2017
Externally publishedYes

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Cohort Studies
Retrospective Studies
Spine
Neoplasm Metastasis
Safety
Neoplasms
Life Expectancy
Therapeutics
Back Muscles
Pain
Erythrocyte Transfusion
Bed Rest
Minimally Invasive Surgical Procedures
Palliative Care
Postoperative Period
Drainage
Length of Stay
Demography
Infection
Research

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Hikata, Tomohiro ; Isogai, Norihiro ; Shiono, Yuta ; Funao, Haruki ; Okada, Eijiro ; Fujita, Nobuyuki ; Iwanami, Akio ; Watanabe, Kota ; Tsuji, Takashi ; Nakamura, Masaya ; Matsumoto, Morio ; Ishii, Ken. / A Retrospective Cohort Study Comparing the Safety and Efficacy of Minimally Invasive Versus Open Surgical Techniques in the Treatment of Spinal Metastases. In: Clinical Spine Surgery. 2017 ; Vol. 30, No. 8. pp. E1082-E1087.
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abstract = "Study Design: A retrospective cohort study. Objective: This study was conducted to assess the invasiveness, efficacy, and safety of minimally invasive spine stabilization (MISt) for metastatic spinal tumor patients with short life expectancy. Summary of Background Data: Conventional open surgery for metastatic spinal tumors has the disadvantages of significant blood loss, potential infection, damage to back muscles, and extended hospital stays. The minimally invasive spine surgery has changed the treatment of metastatic spinal tumors radically and fundamentally. Materials and Methods: We retrospectively reviewed data from 50 consecutive patients registered with the Keio Spine Research Group (KSRG) who underwent posterior palliative surgery for metastatic spinal tumors from January 2009 to June 2015. Of these, 25 patients underwent MISt surgery (M group), and 25 underwent conventional open surgery (C group). The patients were assessed by demographic data, surgical invasiveness, complications, pain improvement, and neurological recovery. Results: The 2 groups did not differ significantly in baseline characteristics. The M group had significantly less blood loss (M, 340.1 mL; C, 714.3 mL; P=0.005), less postoperative drainage (M, 136.0 mL; C, 627.0 mL; P<0.001), lower rates of red blood cell transfusion (M, 3 cases; C, 10 cases; P=0.029), and a shorter postoperative period of bed rest (M, 2.0 d; C, 3.6 d; P<0.001), compared with the C group. The perioperative complication rates were significantly lower (P=0.012) in the M group (3 patients, 12{\%}) than in the C group (11 patients, 44{\%}). Neurological deficits and pain improved significantly and comparably in the 2 groups after surgery. Conclusions: MISt is a less invasive and effective alternative surgery to conventional open surgery for metastatic spinal tumors. MISt should be considered as a valid option for the treatment of metastatic spinal tumor patients with a short life expectancy. Level of Evidence: Level 3.",
author = "Tomohiro Hikata and Norihiro Isogai and Yuta Shiono and Haruki Funao and Eijiro Okada and Nobuyuki Fujita and Akio Iwanami and Kota Watanabe and Takashi Tsuji and Masaya Nakamura and Morio Matsumoto and Ken Ishii",
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Hikata, T, Isogai, N, Shiono, Y, Funao, H, Okada, E, Fujita, N, Iwanami, A, Watanabe, K, Tsuji, T, Nakamura, M, Matsumoto, M & Ishii, K 2017, 'A Retrospective Cohort Study Comparing the Safety and Efficacy of Minimally Invasive Versus Open Surgical Techniques in the Treatment of Spinal Metastases', Clinical Spine Surgery, vol. 30, no. 8, pp. E1082-E1087. https://doi.org/10.1097/BSD.0000000000000460

A Retrospective Cohort Study Comparing the Safety and Efficacy of Minimally Invasive Versus Open Surgical Techniques in the Treatment of Spinal Metastases. / Hikata, Tomohiro; Isogai, Norihiro; Shiono, Yuta; Funao, Haruki; Okada, Eijiro; Fujita, Nobuyuki; Iwanami, Akio; Watanabe, Kota; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Ishii, Ken.

In: Clinical Spine Surgery, Vol. 30, No. 8, 01.01.2017, p. E1082-E1087.

Research output: Contribution to journalArticle

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T1 - A Retrospective Cohort Study Comparing the Safety and Efficacy of Minimally Invasive Versus Open Surgical Techniques in the Treatment of Spinal Metastases

AU - Hikata, Tomohiro

AU - Isogai, Norihiro

AU - Shiono, Yuta

AU - Funao, Haruki

AU - Okada, Eijiro

AU - Fujita, Nobuyuki

AU - Iwanami, Akio

AU - Watanabe, Kota

AU - Tsuji, Takashi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Ishii, Ken

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N2 - Study Design: A retrospective cohort study. Objective: This study was conducted to assess the invasiveness, efficacy, and safety of minimally invasive spine stabilization (MISt) for metastatic spinal tumor patients with short life expectancy. Summary of Background Data: Conventional open surgery for metastatic spinal tumors has the disadvantages of significant blood loss, potential infection, damage to back muscles, and extended hospital stays. The minimally invasive spine surgery has changed the treatment of metastatic spinal tumors radically and fundamentally. Materials and Methods: We retrospectively reviewed data from 50 consecutive patients registered with the Keio Spine Research Group (KSRG) who underwent posterior palliative surgery for metastatic spinal tumors from January 2009 to June 2015. Of these, 25 patients underwent MISt surgery (M group), and 25 underwent conventional open surgery (C group). The patients were assessed by demographic data, surgical invasiveness, complications, pain improvement, and neurological recovery. Results: The 2 groups did not differ significantly in baseline characteristics. The M group had significantly less blood loss (M, 340.1 mL; C, 714.3 mL; P=0.005), less postoperative drainage (M, 136.0 mL; C, 627.0 mL; P<0.001), lower rates of red blood cell transfusion (M, 3 cases; C, 10 cases; P=0.029), and a shorter postoperative period of bed rest (M, 2.0 d; C, 3.6 d; P<0.001), compared with the C group. The perioperative complication rates were significantly lower (P=0.012) in the M group (3 patients, 12%) than in the C group (11 patients, 44%). Neurological deficits and pain improved significantly and comparably in the 2 groups after surgery. Conclusions: MISt is a less invasive and effective alternative surgery to conventional open surgery for metastatic spinal tumors. MISt should be considered as a valid option for the treatment of metastatic spinal tumor patients with a short life expectancy. Level of Evidence: Level 3.

AB - Study Design: A retrospective cohort study. Objective: This study was conducted to assess the invasiveness, efficacy, and safety of minimally invasive spine stabilization (MISt) for metastatic spinal tumor patients with short life expectancy. Summary of Background Data: Conventional open surgery for metastatic spinal tumors has the disadvantages of significant blood loss, potential infection, damage to back muscles, and extended hospital stays. The minimally invasive spine surgery has changed the treatment of metastatic spinal tumors radically and fundamentally. Materials and Methods: We retrospectively reviewed data from 50 consecutive patients registered with the Keio Spine Research Group (KSRG) who underwent posterior palliative surgery for metastatic spinal tumors from January 2009 to June 2015. Of these, 25 patients underwent MISt surgery (M group), and 25 underwent conventional open surgery (C group). The patients were assessed by demographic data, surgical invasiveness, complications, pain improvement, and neurological recovery. Results: The 2 groups did not differ significantly in baseline characteristics. The M group had significantly less blood loss (M, 340.1 mL; C, 714.3 mL; P=0.005), less postoperative drainage (M, 136.0 mL; C, 627.0 mL; P<0.001), lower rates of red blood cell transfusion (M, 3 cases; C, 10 cases; P=0.029), and a shorter postoperative period of bed rest (M, 2.0 d; C, 3.6 d; P<0.001), compared with the C group. The perioperative complication rates were significantly lower (P=0.012) in the M group (3 patients, 12%) than in the C group (11 patients, 44%). Neurological deficits and pain improved significantly and comparably in the 2 groups after surgery. Conclusions: MISt is a less invasive and effective alternative surgery to conventional open surgery for metastatic spinal tumors. MISt should be considered as a valid option for the treatment of metastatic spinal tumor patients with a short life expectancy. Level of Evidence: Level 3.

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