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Review article
peer-reviewed

Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors



Abstract

Patients with metastatic spinal disease are affected by disabling pain. The treatment of spinal metastases is focused on pain reduction and improvement in quality of life. Until recently, many patients with metastatic spinal disease did not qualify as surgical candidates due to the risks of surgery and length of recovery period. However, recent advances in minimally invasive surgery such as kyphoplasty and vertebroplasty allow patients to safely undergo surgery for pain relief with a short recovery period.

The studies reviewed here suggest that vertebral augmentation is successful in reducing pain and disability scores in patients with painful metastases and multiple myeloma and are a safe modality to provide lasting pain relief. As the use of kyphoplasty and vertebroplasty for treatment of vertebral metastases is becoming more common, new combinations of cement augmentation with other techniques such as percutaneous pedicle screws and radiofrequency ablation are being explored. The implementation of kyphoplasty and vertebroplasty, in conjunction with other minimally invasive surgical techniques as well as nonsurgical modalities, may lead to the best palliative management of cancer patients with spinal metastases and help them ultimately achieve a better quality of life.



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Review article
peer-reviewed

Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors


Author Information

Omid R. Hariri Corresponding Author

Department of Neurosurgery, Stanford University School of Medicine

Ariel Takayanagi

Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

Dan E. Miulli

Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

Javed Siddiqi

Institute of Clinical Orthopedic and Neurosciences (Icon), Desert Regional Medical Center, Palm Springs, Ca

Frank Vrionis

Department of Neurological Surgery, Marcus Neuroscience Institute, Boca Raton, Florida, United States


Ethics Statement and Conflict of Interest Disclosures

Conflicts of interest: The authors have declared that no conflicts of interest exist.


Review article
peer-reviewed

Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors


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Review article
peer-reviewed

Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors

  • Author Information
    Omid R. Hariri Corresponding Author

    Department of Neurosurgery, Stanford University School of Medicine

    Ariel Takayanagi

    Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

    Dan E. Miulli

    Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

    Javed Siddiqi

    Institute of Clinical Orthopedic and Neurosciences (Icon), Desert Regional Medical Center, Palm Springs, Ca

    Frank Vrionis

    Department of Neurological Surgery, Marcus Neuroscience Institute, Boca Raton, Florida, United States


    Ethics Statement and Conflict of Interest Disclosures

    Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: March 24, 2017

    DOI

    10.7759/cureus.1114

    Cite this article as:

    Hariri O R, Takayanagi A, Miulli D E, et al. (March 24, 2017) Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors. Cureus 9(3): e1114. doi:10.7759/cureus.1114

    Publication history

    Received by Cureus: January 22, 2017
    Peer review began: March 03, 2017
    Peer review concluded: March 21, 2017
    Published: March 24, 2017

    Copyright

    © Copyright 2017
    Hariri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Patients with metastatic spinal disease are affected by disabling pain. The treatment of spinal metastases is focused on pain reduction and improvement in quality of life. Until recently, many patients with metastatic spinal disease did not qualify as surgical candidates due to the risks of surgery and length of recovery period. However, recent advances in minimally invasive surgery such as kyphoplasty and vertebroplasty allow patients to safely undergo surgery for pain relief with a short recovery period.

The studies reviewed here suggest that vertebral augmentation is successful in reducing pain and disability scores in patients with painful metastases and multiple myeloma and are a safe modality to provide lasting pain relief. As the use of kyphoplasty and vertebroplasty for treatment of vertebral metastases is becoming more common, new combinations of cement augmentation with other techniques such as percutaneous pedicle screws and radiofrequency ablation are being explored. The implementation of kyphoplasty and vertebroplasty, in conjunction with other minimally invasive surgical techniques as well as nonsurgical modalities, may lead to the best palliative management of cancer patients with spinal metastases and help them ultimately achieve a better quality of life.



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Create a free account to continue reading this article.

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Omid R. Hariri, D.O., M.Sc.

Department of Neurosurgery, Stanford University School of Medicine

For correspondence:
ohaririucla@gmail.com

Ariel Takayanagi

Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

Dan E. Miulli

Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

Javed Siddiqi

Institute of Clinical Orthopedic and Neurosciences (Icon), Desert Regional Medical Center, Palm Springs, Ca

Frank Vrionis

Department of Neurological Surgery, Marcus Neuroscience Institute, Boca Raton, Florida, United States

Omid R. Hariri, D.O., M.Sc.

Department of Neurosurgery, Stanford University School of Medicine

For correspondence:
ohaririucla@gmail.com

Ariel Takayanagi

Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

Dan E. Miulli

Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States

Javed Siddiqi

Institute of Clinical Orthopedic and Neurosciences (Icon), Desert Regional Medical Center, Palm Springs, Ca

Frank Vrionis

Department of Neurological Surgery, Marcus Neuroscience Institute, Boca Raton, Florida, United States