Minim Invasive Neurosurg 2009; 52(3): 141-143
DOI: 10.1055/s-0029-1231067
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Thoracic Corpectomy and Anterior Fusion in a Patient with Metastatic Disease: Case Report and Review of the Literature

S. Keshavarzi 1 , M. S. Park 1 , H. E. Aryan 2 , 3 , C. B. Newman 1 , C. S. Amene 1 , D. Gonda 1 , W. R. Taylor 1
  • 1Division of Neurosurgery, University of California, San Diego, California (UCSD), USA
  • 2Department of Neurosurgery, University of California, San Francisco, California (UCSF), USA
  • 3S Sierra Pacific Orthopaedic & Spine Center, Fresno, California, USA
Further Information

Publication History

Publication Date:
31 July 2009 (online)

Abstract

For patients with metastatic disease to the spine there are numerous surgical approaches for decompression of neural elements and maintenance of mechanical stability. The challenge is to accomplish this while minimizing patient morbidity. Here we report on the feasibility and utility of a minimally invasive extreme lateral approach to the mid to high thoracic spine for anterior decompression and fusion.

References

  • 1 Fourney DR, Gokaslan ZL. Use of ‘‘MAPs’’ for determining the optimal surgical approach to metastatic disease of the thoracolumbar spine: anterior, posterior, or combined.  J Neurosurg Spine. 2005;  2 40-49
  • 2 Bilsky MH, Lis E, Raizer J. et al . The diagnosis and treatment of metastatic spinal tumor.  Oncologist. 1999;  4 459-469
  • 3 Klimo Jr P, Schmidt MH. Surgical management of spinal metastases.  Oncologist. 2004;  9 188-196
  • 4 Yao KC, Boriani S, Gokaslan ZL. et al . En bloc spondylectomy for spinal metastases: a review of techniques.  Neurosurg Focus. 2003;  15 E6
  • 5 Gerszten PC, Welch WC. Current surgical management of metastatic spinal disease.  Oncology (Huntingt). 2000;  14 1013-1024 , discussion 1024, 1029–1030
  • 6 Schaberg J, Gainor BJ. A profile of metastatic carcinoma of the spine.  Spine. 1985;  10 19-20
  • 7 Lada R, Kaminski HJ, Ruff R. Metastatic spinal cord compression. In: Vecht C, ed. Neuro-oncology Part III. Neurological Disorders in Systemic Cancer. Amsterdam: Elsevier Biomedical Publishers 1997: 167-189
  • 8 Senel A, Kaya AH, Kuruoglu E. et al . Circumferential stabilization with ghost screwing after posterior resection of spinal metastases via transpedicular route.  Neurosurg Rev. 2007;  30 131-137
  • 9 Shehadi JA, Sciubba DM, Suk I. et al . Surgical treatment strategies and outcome in patients with breast cancer metastatic to the spine: a review of 87 patients.  Eur Spine J. 2007;  16 1179-1192
  • 10 Muhlbauer M, Pfisterer W, Eyb R. et al . Noncontiguous spinal metastases and plasmocytomas should be operated on through a single posterior midline approach, and circumferential decompression should be performed with individualized reconstruction.  Acta Neurochir (Wien). 2000;  142 1219-1230
  • 11 Visocchi M, Masferrer R, Sonntag VK. et al . Thoracoscopic approaches to the thoracic spine.  Acta Neurochir (Wien). 1998;  140 737-743
  • 12 Ozgur MB, Aryan HE, Pimenta L. et al . Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbod fusion.  The Spine Journal. 2006;  6 435-443
  • 13 Falavigna A, Righesso O, Pinto-Filho DR. et al . Anterior surgical management of the cervicothoracic junction lesions at T1 and T2 vertebral bodies.  Arq Neuropsiquiatr. 2008;  66 ((2-A)) 199-203
  • 14 Acosta Jr FL, Aryan HE, Chi J. et al . Modified paramedian transpedicular approach and spinal reconstruction for intradural tumors of the cervical and cervicothoracic spine: clinical experience.  Spine. 2007;  32 E203-210
  • 15 Le H, Balabhadra R, Park J. et al . Surgical treatment of tumors involving the cervicothoracic junction.  Neurosurg Focus. 2003;  15 E3
  • 16 Kaya RA, Turkmenoglu ON, Koc ON. A perspective for the selection of surgical approaches in patients with upper thoracic and cervicothoracic junction instabilities.  Surg Neurol. 2006;  65 454-463
  • 17 Miscusi M, Bellitti A, Polli FM. Surgical approaches to the cervicothoracic junction.  J Neurosurg Sci. 2005;  49 49-57
  • 18 Sundaresan N, DiGiacinto GV, Krol G. et al . Spondylectomy for malignant tumors of the spine.  J Clin Oncol. 1989;  7 1485-1491
  • 19 Siegal T, Siegal T. Surgical decompression of anterior and posterior malignant epidural tumors compressing the spinal cord: a prospective study.  Neurosurgery. 1985;  17 424-432

Correspondence

S. KeshavarziMD 

Division of Neurosurgery

200 W. Arbor Drive

8893 Suite

San Diego

California 92103-8893

USA

Phone: +1/619/543 55 40

Fax: +1/619/543 27 69

Email: skeshavarzi@ucsd.edu

    >