The Orthopedic clinics of North America
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In most patients who have spinal metastases, treatment is mainly palliative. The conventional surgical methods carry higher risks of complications and postoperative morbidity. ⋯ These procedures can result in less soft tissue trauma, lower blood loss, shorter hospitalization time and are better tolerated by the patients. In this review, the techniques and results of minimally invasive management in spinal metastasis, including percutaneous image-guided interventions (vertebroplasty, kyphoplasty, and radiofrequency ablation) and minimally invasive surgical techniques (endoscopic and minimal access operations), are presented.
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Morbidity of surgical procedures for spine tumors is expected to be worse than for other conditions. This is particularly true for en bloc resections, a technically demanding procedure. ⋯ Reoperations have higher risks because of dissection through scar/fibrosis from previous surgeries and possibly from radiation. Careful planning for treatment is mandatory, and if the surgeon is unsure, referral to a specialty center is necessary.