Mini-open compared with the trans-tubular approach in patients with spinal metastases underwent decompression surgery---a retrospective cohort study

• Published in: BMC cancer Vol. 23; no. 1; p. 1226
• Main Authors: Cui, Yunpeng, Mi, Chuan, Wang, Bing, Pan, Yuanxing, Lin, Yunfei, Shi, Xuedong
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 13.12.2023; BioMed Central; BMC
• Subjects: Blood; Blood transfusion; Blood transfusions; Cardiovascular disease; Care and treatment; Cohort analysis; Comparative analysis; Complications and side effects; Decompression; Denosumab; Hospitalization; Medical research; Medicine, Experimental; Metastases; Metastasis; Mini-open; Minimally invasive spine Surgery; Missing data; Patients; Quality of life; Spinal metastases; Spine; Surgeons; Surgery; Surgical drains; Surgical outcomes; Trans-tubular; Tumors; Wound drainage; Zoledronic acid; China; Mini-open; Trans-tubular; Spinal metastases; Minimally invasive spine Surgery
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-023-11730-4

This study aimed to evaluate the perioperative safety and efficacy of the Mini-open and trans-tubular approach in patients with spinal metastases who underwent decompression surgery. 37 consecutive patients with spinal metastases who underwent decompression surgery through a Mini-open or trans-tubular approach were retrospectively reviewed between June 2017 and June 2022. Thirty-four patients were included in this study. 19 underwent decompression surgery through the Mini-open approach, and 15 underwent the Trans-tubular approach. T-test and chi-square test were used to evaluate the difference between baseline data and primary and secondary outcomes. Baseline characteristics did not differ significantly between Trans-tubular and Mini-open groups except for the Ambulatory status (P < 0.001). There was no significant difference in blood loss between the two groups (P = 0.061). Operative time, intraoperative blood transfusion, intraoperative complication (dural tear), and postoperative hospitalization were comparable in the two groups (P > 0.05). The trans-tubular group had significantly less amount of postoperative drainage (133.5 ± 30.9 ml vs. 364.5 ± 64.2 ml, p = 0.003), and the time of drainage (3.1 ± 0.2 days vs. 4.6 ± 0.5 days, p = 0.019) compared with Mini-open group (P < 0.05). Sub-group analysis showed that for patients with hypo-vascular tumors, the Trans-tubular group had significantly less blood loss than the Mini-open group (951.1 ± 171.7 ml vs. 1599.1 ± 105.7 ml, P = 0.026). Decompression through Mini-open or Trans-tubular was safe and effective for patients with spinal metastases. The trans-tubular approach might be more suitable for patients with hypo-vascular tumors.