The Potential of Minimally Invasive Surgery to Treat Metastatic Spinal Disease versus Open Surgery: A Systematic Review and Meta-Analysis

Victor M. Lu, Mohammed Ali Alvi, Anshit Goyal, Panagiotis Kerezoudis, Mohamad Bydon

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Objective: Metastasis to the spinal column is a common feature of primary tumors of the breast, prostate, lung, and other organs. Surgical intervention can be performed via the traditional open surgery (OS) approach or the minimally invasive surgery (MIS) approach. This study aims to assess the available evidence of perioperative outcomes of MIS versus OS for patients with metastatic spinal disease. Methods: We followed recommended PRISMA guidelines for systematic reviews. Six electronic databases were searched to identify all potentially relevant studies published from inception to October 2017. Data were extracted and analyzed using meta-analysis of proportions. Results: Six studies satisfied the criteria for inclusion into this study. There were 292 patients with metastatic spinal disease described in the cohort, treated with either MIS (n = 155, 53%) or OS (n = 137, 47%). Compared with OS, MIS resulted in statistically significant reduction in blood loss (mean difference, -601.48 mL; P < 0.001) and length of stay (mean difference, -4.60 days; P = 0.002). In terms of complications, MIS had a significantly reduced incidence compared with OS (21/155 [14%] and 37/136 [27%], respectively; odds ratio, 0.41; P = 0.005). In terms of operation duration (P = 0.43), postoperative functional (P = 0.76) and pain (P = 0.84) outcomes, MIS was noninferior to OS. Conclusions: Surgical intervention by an MIS approach in patients with metastatic spinal disease seems to provide equivalent outcomes compared with OS and reduces morbidity and length of stay. Future studies that are larger, prospective, and longer-term will validate the findings of this study and elucidate the optimal role for MIS in the surgical management of metastatic spinal disease.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Spinal Diseases
Minimally Invasive Surgical Procedures
Meta-Analysis
Length of Stay
Prostate
Spine
Odds Ratio
Databases
Prospective Studies
Guidelines
Breast Neoplasms
Neoplasm Metastasis
Morbidity
Pain
Lung

Keywords

  • Cancer
  • Metastases
  • Metastatic spine disease
  • Minimally invasive surgery
  • Open surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

The Potential of Minimally Invasive Surgery to Treat Metastatic Spinal Disease versus Open Surgery : A Systematic Review and Meta-Analysis. / Lu, Victor M.; Alvi, Mohammed Ali; Goyal, Anshit; Kerezoudis, Panagiotis; Bydon, Mohamad.

In: World Neurosurgery, 01.01.2018.

Research output: Contribution to journalArticle

Lu, Victor M. ; Alvi, Mohammed Ali ; Goyal, Anshit ; Kerezoudis, Panagiotis ; Bydon, Mohamad. / The Potential of Minimally Invasive Surgery to Treat Metastatic Spinal Disease versus Open Surgery : A Systematic Review and Meta-Analysis. In: World Neurosurgery. 2018.
@article{3c23d614842c4294b909711b26e5a5b4,
title = "The Potential of Minimally Invasive Surgery to Treat Metastatic Spinal Disease versus Open Surgery: A Systematic Review and Meta-Analysis",
abstract = "Background and Objective: Metastasis to the spinal column is a common feature of primary tumors of the breast, prostate, lung, and other organs. Surgical intervention can be performed via the traditional open surgery (OS) approach or the minimally invasive surgery (MIS) approach. This study aims to assess the available evidence of perioperative outcomes of MIS versus OS for patients with metastatic spinal disease. Methods: We followed recommended PRISMA guidelines for systematic reviews. Six electronic databases were searched to identify all potentially relevant studies published from inception to October 2017. Data were extracted and analyzed using meta-analysis of proportions. Results: Six studies satisfied the criteria for inclusion into this study. There were 292 patients with metastatic spinal disease described in the cohort, treated with either MIS (n = 155, 53{\%}) or OS (n = 137, 47{\%}). Compared with OS, MIS resulted in statistically significant reduction in blood loss (mean difference, -601.48 mL; P < 0.001) and length of stay (mean difference, -4.60 days; P = 0.002). In terms of complications, MIS had a significantly reduced incidence compared with OS (21/155 [14{\%}] and 37/136 [27{\%}], respectively; odds ratio, 0.41; P = 0.005). In terms of operation duration (P = 0.43), postoperative functional (P = 0.76) and pain (P = 0.84) outcomes, MIS was noninferior to OS. Conclusions: Surgical intervention by an MIS approach in patients with metastatic spinal disease seems to provide equivalent outcomes compared with OS and reduces morbidity and length of stay. Future studies that are larger, prospective, and longer-term will validate the findings of this study and elucidate the optimal role for MIS in the surgical management of metastatic spinal disease.",
keywords = "Cancer, Metastases, Metastatic spine disease, Minimally invasive surgery, Open surgery",
author = "Lu, {Victor M.} and Alvi, {Mohammed Ali} and Anshit Goyal and Panagiotis Kerezoudis and Mohamad Bydon",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2018.01.176",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - The Potential of Minimally Invasive Surgery to Treat Metastatic Spinal Disease versus Open Surgery

T2 - A Systematic Review and Meta-Analysis

AU - Lu, Victor M.

AU - Alvi, Mohammed Ali

AU - Goyal, Anshit

AU - Kerezoudis, Panagiotis

AU - Bydon, Mohamad

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Objective: Metastasis to the spinal column is a common feature of primary tumors of the breast, prostate, lung, and other organs. Surgical intervention can be performed via the traditional open surgery (OS) approach or the minimally invasive surgery (MIS) approach. This study aims to assess the available evidence of perioperative outcomes of MIS versus OS for patients with metastatic spinal disease. Methods: We followed recommended PRISMA guidelines for systematic reviews. Six electronic databases were searched to identify all potentially relevant studies published from inception to October 2017. Data were extracted and analyzed using meta-analysis of proportions. Results: Six studies satisfied the criteria for inclusion into this study. There were 292 patients with metastatic spinal disease described in the cohort, treated with either MIS (n = 155, 53%) or OS (n = 137, 47%). Compared with OS, MIS resulted in statistically significant reduction in blood loss (mean difference, -601.48 mL; P < 0.001) and length of stay (mean difference, -4.60 days; P = 0.002). In terms of complications, MIS had a significantly reduced incidence compared with OS (21/155 [14%] and 37/136 [27%], respectively; odds ratio, 0.41; P = 0.005). In terms of operation duration (P = 0.43), postoperative functional (P = 0.76) and pain (P = 0.84) outcomes, MIS was noninferior to OS. Conclusions: Surgical intervention by an MIS approach in patients with metastatic spinal disease seems to provide equivalent outcomes compared with OS and reduces morbidity and length of stay. Future studies that are larger, prospective, and longer-term will validate the findings of this study and elucidate the optimal role for MIS in the surgical management of metastatic spinal disease.

AB - Background and Objective: Metastasis to the spinal column is a common feature of primary tumors of the breast, prostate, lung, and other organs. Surgical intervention can be performed via the traditional open surgery (OS) approach or the minimally invasive surgery (MIS) approach. This study aims to assess the available evidence of perioperative outcomes of MIS versus OS for patients with metastatic spinal disease. Methods: We followed recommended PRISMA guidelines for systematic reviews. Six electronic databases were searched to identify all potentially relevant studies published from inception to October 2017. Data were extracted and analyzed using meta-analysis of proportions. Results: Six studies satisfied the criteria for inclusion into this study. There were 292 patients with metastatic spinal disease described in the cohort, treated with either MIS (n = 155, 53%) or OS (n = 137, 47%). Compared with OS, MIS resulted in statistically significant reduction in blood loss (mean difference, -601.48 mL; P < 0.001) and length of stay (mean difference, -4.60 days; P = 0.002). In terms of complications, MIS had a significantly reduced incidence compared with OS (21/155 [14%] and 37/136 [27%], respectively; odds ratio, 0.41; P = 0.005). In terms of operation duration (P = 0.43), postoperative functional (P = 0.76) and pain (P = 0.84) outcomes, MIS was noninferior to OS. Conclusions: Surgical intervention by an MIS approach in patients with metastatic spinal disease seems to provide equivalent outcomes compared with OS and reduces morbidity and length of stay. Future studies that are larger, prospective, and longer-term will validate the findings of this study and elucidate the optimal role for MIS in the surgical management of metastatic spinal disease.

KW - Cancer

KW - Metastases

KW - Metastatic spine disease

KW - Minimally invasive surgery

KW - Open surgery

UR - http://www.scopus.com/inward/record.url?scp=85042412601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042412601&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2018.01.176

DO - 10.1016/j.wneu.2018.01.176

M3 - Article

C2 - 29408300

AN - SCOPUS:85042412601

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -