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Percutaneous Stabilization

  • Ori Barzilai
  • Mark H. Bilsky
  • Ilya Laufer
Chapter

Abstract

Neoplastic spinal instability serves as an independent surgical indication as radiation and systemic cancer treatment do not restore spinal stability. In the setting of spinal instability with low-grade epidural disease and without spinal cord or nerve root compromise, percutaneous stabilization offers short operative times with minimal blood loss, quick recovery, and rapid return to systemic therapy. Utilization of minimally invasive surgery to restore spinal stability offers palliative benefit in reducing instability-associated pain and improvement of quality of life. Widespread use of navigation systems has allowed better understanding of their advantages and pitfalls. These systems improve the accuracy and safety of pedicle screw placement, especially in more complex spinal deformities, while eliminating operating room staff radiation exposure. Technological and engineering advances have brought forth a variety of percutaneous stabilization systems, each with unique strengths and limitations. With the growing complexity of decision-making in cancer care, it is important that surgeons familiarize with cancer treatment paradigms to facilitate decision-making and provide safe, adequate, and timely therapies. One option is the Neurologic, Oncologic, Mechanical stability and Systemic (NOMS) framework. Modern cancer therapies have improved overall survival times, and spinal metastatic disease is commonly diagnosed. The utilization of minimally invasive surgical techniques, such as percutaneous stabilization, is likely to grow. Surgeons must study the procedural aspects of minimally invasive surgery including complication avoidance, staff radiation safety, and technical troubleshooting.

Keywords

Spine Tumor Percutaneous Minimally invasive surgery (MIS) Minimal access surgery (MAS) Spinal stabilization Spinal metastases 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Memorial Sloan Kettering Cancer Center, Department of NeurosurgeryNew YorkUSA
  2. 2.Department of Neurological Surgery, Weill Cornell Medical CollegeNew YorkUSA

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