When Would Minimally Invasive Spinal Surgery Not Be Preferable for Metastatic Spine Disease?

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Oncology

Background:

• Metastatic spine tumor surgery (MSTS) is a key treatment for metastatic spinal disease (MSD).
• Minimally invasive spinal surgery (MISS) has become the preferred approach over open spine surgery (OSS).
• However, MISS is not always suitable for all MSD cases.

Purpose of the Study:

• To identify situations where MISS may be less applicable in MSTS.
• To emphasize the importance of individualized treatment for MSD.
• To highlight the continued relevance of OSS in specific clinical contexts.

Main Methods:

• A narrative review of studies on open spine surgery (OSS) and minimally invasive spinal surgery (MISS) in MSTS.
• Inclusion of 54 relevant studies.

Main Results:

• MISS offers advantages for MSD, considering patient profile, tumor location, and tumor characteristics.
• Factors influencing the choice between MISS and OSS include equipment availability and patient-specific details.
• The review identified specific scenarios where MISS is not ideal.

Conclusions:

• MISS is not universally applicable for MSTS; individualized treatment is essential.
• Surgeon experience is a critical factor in selecting the appropriate surgical technique.
• Open spine surgery (OSS) remains a valuable and time-tested option for MSTS when indicated.