In addition to
radiotherapy, the utility of
surgical decompression and stabilization in patients with metastatic vertebral body
tumors causing cord compression, progressive
deformity and/or
intractable pain has been well demonstrated. Minimally invasive approaches are an attractive alternative to traditional procedures as they may reduce the degree of disruption of normal anatomy, decrease blood loss, shorten
hospital stays and reduce the risk of
infection or
wound dehiscence. The extreme lateral approach is a procedure that provides access to the anterior spine through a small incision along the flank utilizing a unique retractor system without disruption of posterior vertebral elements, spinal musculature and ligaments. A review of two senior surgeons' databases was performed between June 2010 and October 2014 to identify patients with metastatic vertebral body
tumors who were treated surgically at the University of Miami during this period. We report the results of eight cases in which the extreme lateral approach was employed to perform a corpectomy and cage reconstruction for metastatic disease of the thoracic and lumbar vertebral bodies. Each case was supplemented by posterior percutaneous or less commonly open
pedicle screw instrumentation. Postoperative imaging demonstrated excellent
decompression of neural elements as well as
deformity correction, and all patients maintained or improved neurologic function. There were no instances of
wound dehiscence or
infection. Our results indicate that the extreme lateral approach can be effectively used to excise metastatic vertebral body lesions of the thoracolumbar spine causing spinal cord and/or
nerve root compression and spinal
deformity.