Management of Minimally Invasive Spine Surgery in Spinal Metastases: A Comprehensive Systematic Review and Meta-Analysis on Strategies, Treatments, and Outcomes

Daniel  Encarnacion-Santos; Gennady  Chmutin; Egor  Chmutin; Stepan A  Kudryakov; Petr  Baygushev; Renat  Nurmukhametov; Medet  Donasov; Dilerbek  Nuriddinov; Arstanbekov  Beksultan; Nazmin Ahmed Ahmed; Sultan Mujib  Dabiry; Peter Magembe  Mrimba; Bipin  Chaurasia

doi:10.18502/jost.v12i3.22003

Daniel Encarnacion-Santos Resident, Department of Neurosurgery, Russian People's Friendship University, Moscow, Russia
Gennady Chmutin Professor, Department of Neurosurgery, Russian People's Friendship University, Moscow, Russia
Egor Chmutin Associate Professor, Department of Neurosurgery, Russian People's Friendship University, Moscow, Russia
Stepan A Kudryakov Division of Vertebrology, Petrovskovo Academy, Moscow, Russia
Petr Baygushev Division of Vertebrology, Petrovskovo Academy, Moscow, Russia
Renat Nurmukhametov Associate Professor; Division of Vertebrology, Petrovskovo Academy, Moscow, Russia
Medet Donasov Department of Neurosurgery, Petrovskovo Academy, Moscow, Russia
Dilerbek Nuriddinov Resident, Department of Neurosurgery, Russian People's Friendship University, Moscow, Russia
Arstanbekov Beksultan Resident, Department of Neurosurgery, Russian People's Friendship University, Moscow, Russia
Nazmin Ahmed Ahmed Neurosurgeon, Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute, Shahbag, Dhaka, Bangladesh
Sultan Mujib Dabiry Medical Student, School of Medicine, Yuksek Ihtisas University, Ankara, Turkey
Peter Magembe Mrimba Orthopedic Surgeon, Kilimanjaro Christian Medical University College, Moshi, Tanzania
Bipin Chaurasia Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal

DOI: https://doi.org/10.18502/jost.v12i3.22003

Keywords: Minimally Invasive Surgery; Metastases; Kyphoplasty; Vertebroplasty

Abstract

Background: Minimally invasive spine surgery (MISS) represents an effective and increasingly adopted treatment strategy for spinal metastases. Over one million Americans are diagnosed with spinal metastases each year, and just 1.5 million are reported to be diagnosed; only 40-70 percent are spinal metastases. More advanced current percutaneous treatments such as kyphoplasty and vertebroplasty have improved the status of patients previously ruled out for surgery. Osteoblastic and osteolytic spinal metastases can be assessed and treated with percutaneous microwave ablation.

Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The comprehensive search involved several databases, including ScienceDirect and PubMed/MEDLINE, and was performed using the PRISMA guidelines, R software, and Excel. Search terms included “minimally invasive approach in metastatic lesions of the spine and spinal cord” combined with terms specifying surgical techniques, rehabilitation methods, and associated pathologies. Only studies published in English from January 2012 to February 2025 were included.

Results: Our study was based on a comprehensive systematic review and meta-analysis of 2380 patients with spinal metastases who were treated with minimally invasive and traditional open approaches, specifically vertebroplasty and kyphoplasty. We found 1090 patients (46%) with spinal metastases, where 509 cases (21%) were treated with the minimally invasive approach (MISS), while the traditional open approach [traditional open surgery (TOS)] was used for 432 patients (18%). 1611 patients (67%) were intervened by the leves of the fractures. Affected levels, whose cement breaches were 752 patients (31%) with metastases and CSF leaking.

Conclusion: New concepts were also employed in the minimally invasive, open approach which began with minimally invasive procedures such as vertebroplasty and kyphoplasty, and proceeded to treatments like percutaneous microwave ablation. Simple radiation therapy and chemotherapy, including the use of second-generation bisphosphonates such as pamidronate, are recommended, as well as steroids such as dexamethasone and methylprednisolone