Safety and efficacy of minimally invasive small incision decompression surgery for the treatment of thoracolumbar metastatic cancer

English Keywords:Spinal metastatic cancer  Small incision  Minimally invasive spinal surgery  Blood loss  Blood transfusion

English Abstract:

  【Abstract】 Objectives: This study aims to evaluate the safety and efficacy of minimally invasive small incision decompression surgery for patients with thoracolumbar metastatic cancer. Methods: A retrospective analysis was conducted on 71 cases of spinal metastases who underwent posterior decompression surgery in our department from June 2017 to March 2024. There were 55 males and 16 females with an average age of 63.9±1.2 years. Among them, 24 patients underwent posterior minimally invasive small incision decompression surgery, and 47 patients underwent routine posterior decompression surgery. Independent sample t-test and chi square test were used to evaluate the differences between the two groups of patients in baseline data such as age, gender, primary tumor pathological type and blood supply, surgical site, and preoperative embolism, as well as the differences in total blood loss, surgical time, surgical complications, postoperative allogeneic blood transfusion volume, postoperative drainage volume and drainage tube retention time, and postoperative hospitalization time. Results: There was no significant difference in baseline data between the two groups of patients(P<0.001). The postoperative blood loss in the minimally invasive small incision group was significantly lower than that in the conventional surgery group(P=0.003). The postoperative blood transfusion(P=0.011), total drainage volume(P=0.000), drainage tube retention time(P=0.000), and postoperative hospital stay(P=0.000) were significantly reduced in the minimally invasive small incision group compared to the conventional surgery group. The decrease in ALB on the first day after surgery in the minimally invasive group was significantly improved compared to the conventional surgery group(P=0.040). There was no significant difference in the incidence of dural injury, postoperative pain, and functional improvement between the two groups of patients. Conclusions: Minimally invasive small incision decompression surgery can effectively reduce surgical blood loss and allogeneic blood transfusion in patients, shorten postoperative hospital stay, and improve surgical complications and postoperative function similar to conventional surgery.