MIS technique for separation surgery in lumbar spine metastatic disease

Neurosurg Focus Video. 2024 Apr 1;10(2):V11. doi: 10.3171/2024.1.FOCVID23222. eCollection 2024 Apr.

Abstract

Around 40% of cancer patients present with spinal metastases (SM), the lumbar spine being the second most involved site (15%-30%) after the thoracic (60%-80%). Since the development of separation surgery, minimally invasive surgery (MIS) has increasingly been applied to approach SM, mirroring benefits yielded in the degenerative realm. Moreover, preoperative embolization potentially enhances local control for certain radioresistant histologies. Carbon fiber-reinforced PEEK hardware reduces image artifact, facilitating more accurate follow-up and radiotherapeutic planning. Additionally, short-segment cement-augmented constructs may be beneficial to decrease surgical morbidity and operative risk in this population. The authors present a lumbar spinal metastasis treated with MIS techniques. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23222.

Keywords: minimally invasive spine surgery; preoperative embolization; separation surgery; spine metastasis; stereotactic radiotherapy.