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KMID : 1148120190090010007
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Journal of Advanced Spine Surgery
2019 Volume.9 No. 1 p.7 ~ p.13
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Percutaneous Pedicle Screw Fixation in Spinal Metastasis: A Preliminary Study
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Park Jae-Woo
Park Sang-Min
Lee Choon-Ki
Chang Bong-Soon
Chang Sam-Yeol
Kim Hyoung-Min
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Abstract
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Study Design: Retrospective cohort study
Objectives: The primary surgical goals when treating a spinal metastasis are usually pain relief and preservation of ambulatory function. Minimally invasive techniques have become popular, being associated with less morbidity and mortality than conventional open surgeries.
Materials and Methods: Between April 2012 and September 2016, 15 consecutive patients underwent percutaneous pedicle screw fixation (PPSF) to treat spinal metastases. We retrospectively analyzed prospectively collected data, including visual analog scale (VAS) pain scores, Frankel scale scores, and complications.
Results: Fifteen patients (8 males, 7 females; mean age 61 years) underwent surgery under general anesthesia. PPSF was performed on all patients, and two with poor bone quality underwent cement augmentation of the manipulated vertebra(e) just prior to pedicle screw insertion. Seven patients underwent fixation plus distraction (indirect decompression via ligamentotaxis) and two laminectomies (direct decompression) of the spinal cord. Two patients developed screw pullout requiring revision surgery. One patient died 7 days after surgery from liver cirrhosis and sepsis. All patients reported that pain was reduced after surgery. After surgery, 12 patients regained ambulatory capacity. Nine patients died during follow-up; the mean overall survival time was 14.1 months.
Conclusions: PPSF is a safe and minimally invasive palliative surgery option for patients with spinal metastases.
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KEYWORD
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Indirect decompression, Minimal invasive surgery, Percutaneous pedicle screw fixation, Spinal metastases
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