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Posterior approaches for symptomatic metastatic spinal cord compression.

Publication ,  Journal Article
Molina, C; Goodwin, CR; Abu-Bonsrah, N; Elder, BD; De la Garza Ramos, R; Sciubba, DM
Published in: Neurosurg Focus
August 2016

Surgical interventions for spinal metastasis are commonly performed for mechanical stabilization, pain relief, preservation of neurological function, and local tumor reduction. Although multiple surgical approaches can be used for the treatment of metastatic spinal lesions, posterior approaches are commonly performed. In this study, the role of posterior surgical procedures in the treatment of spinal metastases was reviewed, including posterior laminectomy with and without instrumentation for stabilization, transpedicular corpectomy, and costotransversectomy. A review of the literature from 1980 to 2015 was performed using Medline, as was a review of the bibliographies of articles meeting preset inclusion criteria, to identify studies on the role of these posterior approaches among adults with spinal metastasis. Thirty-four articles were ultimately analyzed, including 1 randomized controlled trial, 6 prospective cohort studies, and 27 retrospective case reports and/or series. Some of the reviewed articles had Level II evidence indicating that laminectomy with stabilization can be recommended for improvement in neurological outcome and reduction of pain in selected patients. However, the use of laminectomy alone should be carefully considered. Additionally, transpedicular corpectomy and costotransversectomy can be recommended with the expectation of improving neurological outcomes and reducing pain in properly selected patients with spinal metastases. With improvements in the treatment paradigms for patients with spinal metastasis, as well as survival, surgical therapy will continue to play an important role in the management of spinal metastasis. While this review presents a window into determining the utility of posterior approaches, future prospective studies will provide essential data to better define the roles of the various options now available to surgeons in treating spinal metastases.

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Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

August 2016

Volume

41

Issue

2

Start / End Page

E11

Location

United States

Related Subject Headings

  • Spinal Cord Neoplasms
  • Spinal Cord Compression
  • Retrospective Studies
  • Prospective Studies
  • Neurology & Neurosurgery
  • Humans
  • Decompression, Surgical
  • Clinical Trials as Topic
  • 3209 Neurosciences
  • 1109 Neurosciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Molina, C., Goodwin, C. R., Abu-Bonsrah, N., Elder, B. D., De la Garza Ramos, R., & Sciubba, D. M. (2016). Posterior approaches for symptomatic metastatic spinal cord compression. Neurosurg Focus, 41(2), E11. https://doi.org/10.3171/2016.5.FOCUS16129
Molina, Camilo, C Rory Goodwin, Nancy Abu-Bonsrah, Benjamin D. Elder, Rafael De la Garza Ramos, and Daniel M. Sciubba. “Posterior approaches for symptomatic metastatic spinal cord compression.Neurosurg Focus 41, no. 2 (August 2016): E11. https://doi.org/10.3171/2016.5.FOCUS16129.
Molina C, Goodwin CR, Abu-Bonsrah N, Elder BD, De la Garza Ramos R, Sciubba DM. Posterior approaches for symptomatic metastatic spinal cord compression. Neurosurg Focus. 2016 Aug;41(2):E11.
Molina, Camilo, et al. “Posterior approaches for symptomatic metastatic spinal cord compression.Neurosurg Focus, vol. 41, no. 2, Aug. 2016, p. E11. Pubmed, doi:10.3171/2016.5.FOCUS16129.
Molina C, Goodwin CR, Abu-Bonsrah N, Elder BD, De la Garza Ramos R, Sciubba DM. Posterior approaches for symptomatic metastatic spinal cord compression. Neurosurg Focus. 2016 Aug;41(2):E11.

Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

August 2016

Volume

41

Issue

2

Start / End Page

E11

Location

United States

Related Subject Headings

  • Spinal Cord Neoplasms
  • Spinal Cord Compression
  • Retrospective Studies
  • Prospective Studies
  • Neurology & Neurosurgery
  • Humans
  • Decompression, Surgical
  • Clinical Trials as Topic
  • 3209 Neurosciences
  • 1109 Neurosciences