Safety and Efficacy of All-In-One Percutaneous Pedicle Screw System

Study Design: Retrospective study of the prospectively collected outcomes data. Objective: The indications for PPS placement during minimally invasive spine stabilization (MISt) procedures have increased in recent years. To the best of our knowledge, no studies have documented the outcomes of PPS insertion using the all-in-one PPS system. This study compared the conventional methods and the use of all-in-one percutaneous pedicle screw (PPS) system with respect to the speed and accuracy of PPS placement. We also determined the advantages associated with the use of the all-in-one PPS system. Methods: We evaluated 54 patients who underwent PPS insertion using the conventional method and the all-in-one PPS system during MISt procedures. We also assessed the number of implanted PPSs, the time taken to implant PPSs, and the accuracy of PPS placement based on postoperative computed tomography images. Results: A total of 254 PPSs were inserted (126 using the conventional method and 128 using the all-in-one PPS system). The PPS insertion time with the all-in-one PPS system (mean, 25.3 ± 9.1 s) was significantly shorter than that using the conventional method (mean, 63.1 ± 13.0 s; P < 0.01). With respect to the accuracy of PPS insertion, ≥ 2 mm pedicle breach was noted in one case each in both groups. Conclusions: PPS placement using the all-in-one PPS system is as safe as conventional methods and has the potential to save the surgical time of MISt procedures.

Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization

Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabilitation with minimally invasive spine stabilization (MISt) effectively improves ADL.Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with MISt. We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses.Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. Neurological deficiency was improved to or maintained at Frankel’s grade E in 16 patients, remained unchanged in 6 patients (in grades B, C, D), and worsened in 5 patients. BI score comparisons before and after surgery in all patients showed statistically significant increments (p < 0.05). On further analysis, we noted good functional prognosis in patients capable of ambulation within seven days (p < 0.05) and in patients who could survive longer than three months after the surgery (p < 0.05).Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.

Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization: A single-center retrospective study

Background: Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. Methods: We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with minimally invasive spine stabilization (MISt). We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability and tumor growth. The neurological deficits, ambulation status, progress of pathological fracture, incidence of vertebral collapse, postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses. Results: The average duration to ambulation was 7.19±11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. We noted good functional prognosis in patients capable of ambulation within seven days and in patients who could survive longer than three months after the surgery. Conclusions: In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.