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RISS 인기검색어
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- 저자 : Flores-Villalba Eduardo (검색결과 1 건)
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Minimally Invasive versus Open Surgery for Spinal Metastasis: A Systematic Review and Meta-Analysis
Hinojosa-Gonzalez David Eugenio,Roblesgil-Medrano Andres,Villarreal-Espinosa Juan Bernardo,Tellez-Garcia Eduardo,Bueno-Gutierrez Luis Carlos,Rodriguez-Barreda Jose Ramon,Flores-Villalba Eduardo,Martin 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.4
Bones are the third most common location for solid tumor metastasis affecting up to 10% of patients with solid tumors. When the spine is involved, thoracic and lumbar vertebrae are frequently affected. Access to spinal lesions can be through minimally invasive surgery (MIS) or traditional open surgery (OS). This study aims to determine which method provides an advantage. Following the PRISMA (Preferred Inventory for Systematic Reviews and Meta-Analysis) guidelines, a systematic review was conducted to identify studies that compare MIS with OS in patients with spinal metastatic disease. Data were analyzed using Review Manager ver. 5.3 (RevMan; Cochrane, London, UK). Ten studies were included. Operative time was similar among groups at -35.23 minutes (95% confidence interval [CI], -73.36 to 2.91 minutes; <i>p</i>=0.07). Intraoperative bleeding was lower in MIS at -562.59 mL (95% CI, -776.97 to -348.20 mL; <i>p</i><0.00001). OS procedures had higher odds of requiring blood transfusions at 0.26 (95% CI, 0.15 to 0.45; <i>p</i><0.00001). Both approaches instrumented similar numbers of levels at -0.05 levels (95% CI, -0.75 to 0.66 levels; <i>p</i>=0.89). We observed a decreased need for postoperative bed rest at -1.60 days (95% CI, -2.46 to -0.74 days; <i>p</i>=0.0003), a shorter length of stay at -3.08 days (95% CI, -4.50 to -1.66 days; <i>p</i>=0.001), and decreased odds of complications at 0.60 (95% CI, 0.37 to 0.96; <i>p</i>=0.03) in the MIS group. Both approaches revealed similar reintervention rates at 0.65 (95% CI, 0.15 to 2.84; <i>p</i>=0.57), effective rates of reducing metastasis-related pain at -0.74 (95% CI, -2.41 to 0.94; <i>p</i>=0.39), and comparable scores of the Tokuhashi scale at -0.52 (95% CI, -2.08 to 1.05; <i>p</i>=0.41), Frankel scale at 1.00 (95% CI, 0.60 to 1.68; <i>p</i>=1.0), and American Spinal Injury Association Scale at 0.53 (95% CI, 0.21 to 1.37; <i>p</i>=0.19). MIS appears to provide advantages over OS. Larger and prospective studies should fully detail the role of MIS as a treatment for spine metastasis.
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