• Alvaro Silva, Ratko Yurac, Alfredo Guiroy, Oscar Bravo, Morales CiancioAlejandroASpine Unit, Orthopedic Department, Hospital Español de Mendoza, Mendoza, Argentina., Federico Landriel, and Santiago Hem.
• Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. Electronic address: asilvag@alemana.cl.
• World Neurosurg. 2021 Apr 1; 148: e627-e634.

ObjectiveTo evaluate incidence and types of implant failure observed in a series of patients with spinal metastases (SM) treated with minimally invasive stabilization surgery without fusion.MethodsIn this multicenter, retrospective, observational study, we reviewed the files of patients >18 years old who underwent surgery for SM using percutaneous spinal stabilization without fusion with a minimum 3-month follow-up. The following variables were included: demographics, clinical findings, prior radiation history, SM location, epidural spinal cord compression scale, Spinal Instability Neoplastic Scale, neurological examination, and surgery-related data. Primary outcome measure was implant failure rate, as observed in patients' last computed tomography scan. Multivariable analysis was performed to identify baseline factors and factors associated with implant failure.ResultsAnalysis included 72 patients. Mean age of patients was 62 years, 39 patients were men, and 75% of patients had an intermediate Spinal Instability Neoplastic Scale score. Tumor separation surgery was performed in 48.6% of patients. Short instrumentation was indicated in 54.2% of patients. Three patients (4.2%) experienced implant failure (2 screw loosening, 1 screw cut-out); none of them required revision surgery. In 73.6% of cases, survival was >6 months. No significant predictors of failure were identified in the multivariate analysis.ConclusionsA low implant failure rate was observed over the short and medium term, even when short instrumentations without fusion were performed. These findings suggest that minimally invasive stabilization surgery without fusion may be an effective and safe way to treat complicated SM.Copyright © 2021 Elsevier Inc. All rights reserved.

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