Surgical minimally invasive treatment of spine metastases

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Author: 
Dzmitry Dabravolski, Jan Eßer and Harry Merk
Abstract: 

Introduction: A radical surgery of spine metastases is not possible in many cases, especially by elder multimorbid patients. The specialness and possibilities the Cavity/Coblation-method in the operative treatment of 262 patients with spine metastases are here presented.
Materials and Methods: Patients of every age with vertebral destructions caused by spinal metastases were treated.
The tumour tissue resection was carried out by the plasma field over the percutaneous access and was followed by kyphoplasty. Follow up are in 2, 14 days, 3, 6, 12, 24, 36, 48, 60 months postoperatively.
Results: Within 6 years (2008-2014) 262 patients with spine metastases were treated. A small amount of blood loss and a very low complication rate was recorded as well as an obvious reduction of pain, increase in life quality, by all patients. A rapid mobilization was possible as well as the immediate radiation and chemotherapy for reduction of the local tumour recurrence rate. The complications were as follows: by38of 262 (by 38 vertebral bodies from 866 – only in 4,39 %) patients/cases, where large vertebral damage was present, small cement leakage laterally or in the intervertebral disc space were detected without clinical relevance.
Conclusion: Coblation/Cavity has shown itself to be a safe, minimal invasive procedure with good short and long term results, a low complication rate, blood loss and short surgery times. The total local recurrence rate for all patients with spine metastases in the study was by 36 from 262(13,74%) patients with metastases or in 62 of 866 (only 7,16 %) treated vertebral bodies. Local recurrences were successfully treated in all cases by the targeted local radiation therapy and chemotherapy.The method bears much promise for the future.

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