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Comparison the results of surgical treatment of metastatic lesions of the thoracic spine (systematic review)

Year: 2024, volume 20 Issue: №2 Pages: 140-148
Heading: Traumatology and Orthopedics Article type: Review
Authors: Ivliev D.S., Burtsev A.V., Goncharov M.Yu., Lyulin S.V., Ovsyankin A.V., Atroshenko I.G.
Organization: Federal Center for Traumatology Orthopedics and Endoprosthetics, Smolensk, Russia, Medical Center Carmel, Chelyabinsk, Russia, National Medical Research Center of Traumatology and Orthopedics n. a. G.A. Ilizarov, Kurgan, Russia, Smolensk State Medical University, Smolensk, Russia, Sverdlovsk Regional Clinical Psychoneurological Hospital for War Veterans, Yekaterinburg, Russia
Summary:

Objective: to conduct a comparative analysis of the effectiveness of surgical treatment for patients with metastatic lesions of the thoracic spine from anterior and posterior approaches according to the literature. Methodology for writing a review. The search was carried out in the PubMed and Scopus databases. Search words and phrases: "thoracic spine", "metastatic lesion", "spinal cord", "management of thoracic spine metastasis". Search depth for the last 15 years. 13 publications were included in the final analysis. Conclusion. Both approaches are effective, but data such as blood loss, duration of surgery, neurological changes and pain intensity are significantly better in patients who underwent anterior approach. At the same time, in this group the development of respiratory failure is more common, and the 30-day mortality rate is higher compared to group of posterior approach. In the group of posterior interventions there was a significantly higher level of postoperative CSF leakage and wound infection, as well as worsening neurological deteriorations. The frequency of failure of implanted structures and revision interventions for wound hematomas and recurrent tumor growth is almost the same.

Keywords: metastatic lesions of the thoracic spine, transthoracic surgery

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