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Journal of Neurosurgical Sciences 2017 December;61(6):565-78

DOI: 10.23736/S0390-5616.16.03690-0


language: English

Treatment of tumors and metastases of the spine by minimally invasive CAVITY-coblation method (plasma field therapy)

Dzmitry DABRAVOLSKI 1, 2 , Jan EßER 1, Andreas LAHM 1, 3, Harry MERK 1

1 Department of Orthopedics and Orthopedic Surgery, Ernst-Moritz-Arndt University, Greifswald, Germany; 2 Center of Spine Surgery, Clinikum Fichtelgebirge, Marktredwitz, Germany; 3 Tumor Center, Maria Hilf Clinic Mönchengladbach, Academic Teaching Hospital of the RWTH Aachen, Mönchengladbach, Germany


BACKGROUND: A radical surgery of spine metastases is not possible in many cases, especially by elder multi morbid patients. The modern CAVITY/coblation method offers a very good therapeutic alternative for such patients. The goal of this paper was to evaluate and present the method as well as the results of the treatment of 302 patients with vertebral tumors/metastases.
METHODS: Patients with vertebral destructions of the spine caused by spinal tumors and metastases were treated. Diagnosis preoperatively: X-ray, MRT, CT, PET, histology. Tumor tissue resection was carried out by plasma field over the percutaneous transpedicular access and was followed by kyphoplasty. Follow-up with clinical and radiological examinations are in 2, 14 days, 3, 6, 12, 24, 36, 48, 60 months postoperatively.
RESULTS: Within 6 years (04/2008-05/2014) 302 patients (188 female, 114 male, age range of 31-92, average age of 65.4 years) were treated. It was shown by all patients: less blood loss, no seriously complications, pain reduction, increase in life quality. Postoperatively was possible: rapid mobilization, immediate radiation and chemotherapy for reduction of the local tumor recurrence rate.
CONCLUSIONS: CAVITY has shown itself to be a safe, minimal invasive procedure with good short and long term results, a low complication rate, blood loss and short surgery times. The total local recurrence rate was only 13.5%. Important are: comprehensive diagnostic including tumor staging, correct indication, prognostic assessment, precise surgical technique.

KEY WORDS: Spine - Neoplasms - Minimally invasive surgical procedures - Kyphoplasty

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