Minimal access spinal surgery (MASS) in treating thoracic spine metastasis

Tsung Jen Huang, Robert Wen Wei Hsu, Yen Yao Li, Chin Chang Cheng

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

STUDY DESIGN. A retrospective study was conducted. OBJECTIVE. This study aims to analyze the feasibility and efficacy of using minimal access spinal surgery (MASS) for managing thoracic spine metastasis. SUMMARY OF BACKGROUND DATA. Literature regarding minimally invasive surgical treatment for thoracic spine metastasis is sparse. In the past decade, the role of minimally invasive or endoscopic technique in managing metastatic thoracic disease has evolved. METHODS. From February 1997 to March 2003, 46 patients with spine metastases, from T3-T12, were enrolled in this study. There were 29 patients undergoing MASS. Seventeen patients received standard thoracotomy (ST) in the early study period served as the control group. The indications for MASS include intractable back pain and/or neurologic deficits or neurologic deterioration during or after radiotherapy. Inclusion criteria for this study included tumor limited to one or two vertebral segments. RESULTS. In the MASS and ST groups, no patient died as a result of an immediate intraoperative event. The mean operative blood loss was 1,110 versus 1,162 mL (P = 0.63), and the mean operative length was 179 versus 180 minutes (P = 0.54). Complication rates and 1-year, 2-year, and overall survival rates were comparable and the mean grade of neurologic recovery was 1.2 on the Frankel scale in both groups. Only 6.9% of MASS patients required a 2-day postoperative ICU stay compared with 88% of ST patients (P <0.0001). CONCLUSIONS. The MASS technique is safe and effective and has proved to be an excellent alternative in managing thoracic spine metastasis. Surgeons may use progressively smaller incisions (5-6 cm in length) for the procedure. The learning curve for performing MASS procedures was not steep.

Original languageEnglish
Pages (from-to)1860-1863
Number of pages4
JournalSpine
Volume31
Issue number16
DOIs
Publication statusPublished - Jul 2006
Externally publishedYes

Fingerprint

Spine
Thorax
Neoplasm Metastasis
Thoracotomy
Nervous System
Thoracic Diseases
Intractable Pain
Learning Curve
Back Pain
Neurologic Manifestations
Thoracic Surgery
Radiotherapy
Survival Rate
Retrospective Studies
Control Groups
Neoplasms
Therapeutics

Keywords

  • Metastasis
  • Minimal access spinal surgery (MASS)
  • Neurologic deficit
  • Thoracic spine
  • Thoracotomy

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Minimal access spinal surgery (MASS) in treating thoracic spine metastasis. / Huang, Tsung Jen; Hsu, Robert Wen Wei; Li, Yen Yao; Cheng, Chin Chang.

In: Spine, Vol. 31, No. 16, 07.2006, p. 1860-1863.

Research output: Contribution to journalArticle

Huang, Tsung Jen ; Hsu, Robert Wen Wei ; Li, Yen Yao ; Cheng, Chin Chang. / Minimal access spinal surgery (MASS) in treating thoracic spine metastasis. In: Spine. 2006 ; Vol. 31, No. 16. pp. 1860-1863.
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abstract = "STUDY DESIGN. A retrospective study was conducted. OBJECTIVE. This study aims to analyze the feasibility and efficacy of using minimal access spinal surgery (MASS) for managing thoracic spine metastasis. SUMMARY OF BACKGROUND DATA. Literature regarding minimally invasive surgical treatment for thoracic spine metastasis is sparse. In the past decade, the role of minimally invasive or endoscopic technique in managing metastatic thoracic disease has evolved. METHODS. From February 1997 to March 2003, 46 patients with spine metastases, from T3-T12, were enrolled in this study. There were 29 patients undergoing MASS. Seventeen patients received standard thoracotomy (ST) in the early study period served as the control group. The indications for MASS include intractable back pain and/or neurologic deficits or neurologic deterioration during or after radiotherapy. Inclusion criteria for this study included tumor limited to one or two vertebral segments. RESULTS. In the MASS and ST groups, no patient died as a result of an immediate intraoperative event. The mean operative blood loss was 1,110 versus 1,162 mL (P = 0.63), and the mean operative length was 179 versus 180 minutes (P = 0.54). Complication rates and 1-year, 2-year, and overall survival rates were comparable and the mean grade of neurologic recovery was 1.2 on the Frankel scale in both groups. Only 6.9{\%} of MASS patients required a 2-day postoperative ICU stay compared with 88{\%} of ST patients (P <0.0001). CONCLUSIONS. The MASS technique is safe and effective and has proved to be an excellent alternative in managing thoracic spine metastasis. Surgeons may use progressively smaller incisions (5-6 cm in length) for the procedure. The learning curve for performing MASS procedures was not steep.",
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