Comparison of open versus minimally invasive surgery in the treatment of thoracolumbar metastases

Minimally invasive surgery (MIS) techniques have been developed for the surgical treatment of thoracolumbar spinal metastases to reduce the morbidity associated with the operation. The purpose of our study was to compare the mean length of stay, change in pain levels, neurological symptoms, complications and survival after open versus MIS surgery. This is a single-center retrospective study based on a register of patients treated for vertebral metastases between January 2014 and October 2016. The collection included demographic data, cancer-related data, clinical data, the characteristics of the surgery, the length of stay, assessment of pain and the occurrence of death. These data were compared between open and MIS surgery groups. Out of 59 patients, 35 were treated with open surgery and 24 were treated with MIS surgery. The two groups were comparable in terms of age, gender and body mass index. Breast, kidney, prostate and lung cancers were the most frequent primary tumors. Prognostic and instability scores were comparable. Short- and medium-term pain assessment showed comparable results. Median survival was 208 days in the open surgery group and 224days in the MIS group (p=0.5299). MIS techniques aim to limit the surgical approach and allow a faster introduction of adjuvant treatments than after open surgery. Our study did not find any differences between open and MIS surgery in terms of pain, neurological evolution or survival time in patients treated for thoracolumbar spinal metastases. IV; retrospective study. Les techniques de chirurgie minimale invasive (MIS) se sont développées dans le traitement chirurgical des métastases vertébrales thoracolombaires pour réduire la morbidité liée à l’opération. Le but de notre étude était de comparer les durées moyennes de séjour, l’évolution de la douleur, des symptômes neurologiques, des complications et de la survie après chirurgie ouverte versus MIS. Il s’agit d’une étude rétrospective monocentrique à partir d’un registre de patients opérés de métastases vertébrales entre janvier 2014 et octobre 2016. Le recueil comportait des données démographiques, des données liées au cancer, des données cliniques, les caractéristiques de la chirurgie, la durée du séjour, l’évaluation de la douleur et la survenue d’un décès en opposant la chirurgie ouverte et la chirurgie MIS. Sur 59 patients étudiés, 35 étaient opérés par chirurgie ouverte et 24 étaient opérés par chirurgie MIS. Les 2 groupes étaient comparables en terme