Our Summary

The research paper is about a study comparing two types of surgery for treating spinal metastases (cancer that has spread to the spine): minimally invasive surgery (MIS) and conventional open surgery (COS). Both of these surgeries use a technique called “instrumented fusion” and may also include a procedure to relieve pressure on the spinal cord (decompression).

The researchers examined various studies on these surgeries. They looked at things like complications, improvement in nerve function, length of hospital stay, amount of blood lost during surgery, need for blood transfusion, and duration of the surgery.

They found that patients who underwent minimally invasive surgery had fewer complications and less blood loss. They also needed fewer blood transfusions and spent less time in the hospital. However, the improvement in nerve function and the length of the surgery were similar for both types of surgery.

In conclusion, minimally invasive surgery seems to offer some benefits over conventional open surgery for treating spinal metastases, without compromising on the effectiveness of the treatment.

FAQs

  1. What are the two types of surgery for treating spinal metastases discussed in the research paper?
  2. What benefits does minimally invasive surgery have over conventional open surgery in treating spinal metastases?
  3. Was there a difference in improvement in nerve function and surgery duration between minimally invasive surgery and conventional open surgery?

Doctor’s Tip

A helpful tip a doctor might give a patient about spinal surgery is to follow post-operative instructions carefully to ensure proper healing and recovery. This may include restrictions on physical activity, proper wound care, and attending follow-up appointments with your healthcare provider. It is important to communicate any concerns or changes in symptoms with your healthcare team to ensure the best possible outcome after surgery.

Suitable For

Patients who are typically recommended for spinal surgery include those with spinal metastases, spinal cord compression, herniated discs, spinal stenosis, spinal deformities (such as scoliosis), spinal fractures, and other conditions causing nerve compression or instability in the spine. These patients may be experiencing symptoms such as severe back or neck pain, weakness or numbness in the limbs, difficulty walking or standing, and loss of bowel or bladder control. Patients who have not responded to conservative treatments such as medication, physical therapy, or injections may be candidates for spinal surgery. Additionally, patients with progressive neurological deficits or severe pain that significantly impacts their quality of life may also be recommended for surgery.

Timeline

Before spinal surgery, a patient typically goes through a series of steps including initial consultation with a spine surgeon, pre-operative testing such as imaging studies, blood work, and possibly a physical exam. The patient may also need to undergo pre-operative physical therapy or make lifestyle adjustments to prepare for surgery. On the day of surgery, the patient will be admitted to the hospital, undergo anesthesia, and undergo the surgery itself.

After spinal surgery, the patient will initially be monitored in the recovery room before being transferred to a hospital room or a post-operative care unit. The patient will be closely monitored for any complications, and pain management will be provided as needed. Physical therapy and rehabilitation will likely be started soon after surgery to help the patient regain strength and mobility. The patient will also have follow-up appointments with the surgeon to monitor their progress and address any concerns. Over time, the patient should experience improvement in their symptoms and overall quality of life as they recover from the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with minimally invasive surgery compared to conventional open surgery for treating spinal metastases?
  2. How does the recovery process differ between minimally invasive surgery and conventional open surgery for spinal metastases?
  3. Will minimally invasive surgery or conventional open surgery result in better long-term outcomes for treating spinal metastases?
  4. How does the cost of minimally invasive surgery compare to conventional open surgery for spinal metastases?
  5. What factors should I consider when deciding between minimally invasive surgery and conventional open surgery for treating my spinal metastases?
  6. How experienced is the surgical team in performing minimally invasive surgery for spinal metastases?
  7. Are there any specific criteria or conditions that make me a better candidate for minimally invasive surgery over conventional open surgery for spinal metastases?
  8. How long will the effects of minimally invasive surgery last compared to conventional open surgery for spinal metastases?
  9. Are there any alternative treatment options to consider besides minimally invasive surgery and conventional open surgery for spinal metastases?
  10. What is the likelihood of needing additional surgeries or treatments in the future after undergoing minimally invasive surgery or conventional open surgery for spinal metastases?

Reference

Authors: Pranata R, Lim MA, Vania R, Bagus Mahadewa TG. Journal: World Neurosurg. 2021 Apr;148:e264-e274. doi: 10.1016/j.wneu.2020.12.130. Epub 2021 Jan 5. PMID: 33418123