The majority (90%) of metastatic tumors of the spine occur in the thoracic and lumbar region. These tumors can cause instability of the spine, severe pain, and neurologic deficits. Surgical treatment is focused on stabilization, pain reduction, and improvement of quality of life. Many patients do not qualify for conventional open surgery due to medical comorbidities and limited life expectancy when compared to the recovery from surgery. However, minimally invasive surgery allows this group of patients to safely undergo surgery with shorter recovery periods.
The currently utilized minimally invasive procedures for spine stabilization and pain control include vertebral augmentation in the form of kyphoplasty or vertebroplasty, cement augmentation to pedicle screw fixation, and cement reconstruction of vertebral bodies. These procedures are illustrated via individual cases. This surgical modality involves less surgical trauma and proves to be efficient in the management of cancer patients.
This is a preview of subscription content, log in to check access.
Conflict of Interest
We declare no conflict of interest.
Binning MJ, Gottfried ON, Klimo P Jr, Schmidt MH. Minimally invasive treatments for metastatic tumors of the spine. Neurosurg Clin N Am. 2004;15:459–65.CrossRefGoogle Scholar
Gerszten PC, Welch WC. Current surgical management of metastatic spinal disease. Oncology (Williston Park). 2000;14:1013–24.Google Scholar
Sciubba DM, Petteys RJ, Dekutoski MB, Fisher CG, Fehlings MG, Ondra SL, et al. Diagnosis and management of metastatic spine disease. A review. J Neurosurg Spine. 2010;13:94–108.CrossRefGoogle Scholar
Murakami H, Kawahara N, Demura S, Kato S, Yoshioka K, Tomita K. Total en bloc spondylectomy for lung cancer metastasis to the spine. J Neurosurg Spine. 2010;13:414–7.CrossRefGoogle Scholar
Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 2005;30:2186–91.CrossRefGoogle Scholar
Fourney DR, Frangou EM, Ryken TC, Dipaola CP, Shaffrey CI, Berven SH, et al. Spinal instability neoplastic score: an analysis of reliability and validity from the spine oncology study group. J Clin Oncol. 2011;29:3072–7.CrossRefGoogle Scholar
Kim CH, Chung CK, Sohn S, Lee S, Park SB. Less invasive palliative surgery for spinal metastases. J Surg Oncol. 2013;108:499–503.CrossRefGoogle Scholar
Bartolozzi B, Nozzoli C, Pandolfo C, Antonioli E, Guizzardi G, Morichi R, et al. Percutaneous vertebroplasty and kyphoplasty in patients with multiple myeloma. Eur J Haematol. 2006;76:180–1.CrossRefGoogle Scholar
Ha KY, Min CK, Seo JY, Kim YH, Ahn JH, Hyun NM, et al. Bone cement augmentation procedures for spinal pathologic fractures by multiple myeloma. J Korean Med Sci. 2015;30:88–94.CrossRefGoogle Scholar
Tosi P. Diagnosis and treatment of bone disease in multiple myeloma: spotlight on spinal involvement. Scientifica (Cairo). 2013;2013:104546.Google Scholar
Quan R, Ni Y, Zhang L, Xu J, Zheng X, Yang D. Short- and long-term effects of vertebroplastic bone cement on cancellous bone. J Mech Behav Biomed Mater. 2014;35:102–10.CrossRefGoogle Scholar
Tatsui CE, Belsuzarri TA, Oro M, Rhines LD, Li J, Ghia AJ, et al. Percutaneous surgery for treatment of epidural spinal cord compression and spinal instability: technical note. Neurosurg Focus. 2016;41:E2.CrossRefGoogle Scholar
Moussazadeh N, Rubin DG, McLaughlin L, Lis E, Bilsky MH, Laufer I. Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability. Spine J. 2015;15:1609–17.CrossRefGoogle Scholar
Kim P, Kim SW. Bone cement-augmented percutaneous screw fixation for malignant spinal metastases: is it feasible? J Korean Neurosurg Soc. 2017;60:189–94.CrossRefGoogle Scholar
Hariri O, Takayanagi A, Miulli DE, Siddiqi J, Vrionis F. Minimally invasive surgical techniques for management of painful metastatic and primary spinal tumors. Cureus. 2017;9:e1114.PubMedPubMedCentralGoogle Scholar
Abi LG, Abi JS. Role of surgery in the management of vertebral metastases. General revue. Cancer Radiother. 2016;20:484–92.CrossRefGoogle Scholar
Hamad A, Vachtsevanos L, Cattell A, Ockendon M, Balain B. Minimally invasive spinal surgery for the management of symptomatic spinal metastasis. Br J Neurosurg. 2017:1–5.Google Scholar
Fourney DR, et al. Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg. 2003;98(1 suppl):21–30.PubMedGoogle Scholar