Instrumented Spinal Stabilization without Fusion for Spinal Metastatic Disease

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Oncology

Background:

• Spinal stabilization surgery is crucial for spinal metastatic disease.
• Bony fusion, standard in non-oncology patients, is often unachievable in oncology patients due to prognosis and therapies.
• Instrumented spinal stabilization without fusion may be a viable alternative, but literature is limited.

Purpose of the Study:

• To investigate the rate of instrumentation failure in patients undergoing posterior spinal instrumented stabilization without fusion for spinal metastatic disease.

Main Methods:

• Retrospective review of consecutive spinal surgery cases over 81 months.
• Inclusion criteria: laminectomy, posterior spinal instrumentation without fusion for spinal metastases, and >3 months postoperative CT follow-up.
• Data collected: demographics, clinical notes, CT findings for instrumentation failure evaluation.

Main Results:

• Twenty-seven patients (mean age 64.85 years) were analyzed.
• No instrumentation failures (position change, screw pullout, alignment change, progressive deformity) were observed.
• No patients required reoperation, revision, or replacement of instrumentation.

Conclusions:

• Instrumented spinal stabilization without fusion appears to be an acceptable and safe approach for managing spinal metastatic disease.
• This technique avoids the complications associated with fusion in this patient population.
• Further research can validate these findings in larger cohorts.