robot-assisted invasion-controlled surgery versus traditional-open surgery against metastatic spinal tumor

Conditions: Minimally Invasive Surgery; Spinal Metastases

Summary: with significant advances in diagnostic imaging and systemic therapies for oncologic disease, spinal metastasis with neurological dysfunction and mechanical instability has become an indication for surgery. even if traditional-open surgery was palliative, the treatment of spinal metastasis also carried significant surgical morbidity. those high morbidity and complication rates may influence the quality of patients with a limited life expectancy. invasion-controlled surgery was utilized with robot-assisted surgery approach against symptomatic spinal metastasis. increasing interest in the potential for improved consistency, complication reduction, and decreased length of hospitalization through robot utilization is evident from the rapid growth of publications seen in recent years. so, the investigators wish to evaluate the advantages of robot-assisted invasion-controlled surgery compared with traditional-open surgery spinal surgery in patients with metastatic spinal cord compression.

surgical spinal decompression of metastatic spinal cord compression, minimal access versus open surgery. a prospective clinical trial purpose to investigate the effect of robot-assisted invasion-controlled surgery compared with traditional-open surgery in the treatment of patients with metastatic spinalcord compression. hypotheses the group of patient's receiving robot-assisted invasion-controlled surgery will have better improvement in quality after surgery compared to the group that will receive traditional open surgery. the robot-assisted invasion-controlled surgery group will have reduction in per-operative bleeding and less wound complications compered to the group of patients receiving open or traditional surgery.

Eligibility criteria:
inclusion criteria: 1. confirmed diagnosis of spinal metastasis (previously confirmed diagnosis of lung cancer, liver cancer, prostate cancer, breast cancer, kidney cancer, digestive tract cancer, imaging indicated the presence of metastatic lesions in the spine) 2. patients with symptoms of spinal instability or nerve compression (sins score of spinal instability ≥7, spinal nerve compression according to spinal cord injury classification, grade a-d) 3. metastases are located in the thoracic and/or lumbar vertebrae 4. the patient's expected survival was longer than 6 months 5. the subjects or their legal representatives were able to understand the study purpose, demonstrate adequate compliance with the study protocol, and sign informed consent exclusion criteria: 1. he had previously operated on the same site 2. spontaneous multiple compression fractures of the spine; 3. there is malformed osteitis (paget's bone disease), osteomalacia, or other metabolic bone disease; 4. here were developmental vertebral malformations or vertebral body and pedicle dysplasia in the spinal segment to be treated by surgery 5. presence of heart, lung, liver or kidney failure or other serious diseases (such as osteomyelitis, systemic infection, severe hemorrhagic disease, active disseminated intravascular coagulation, serious cardiovascular disease or myocardial infarction within 6 months prior to enrollment, cerebral infarction within 6 months prior to enrollment, severe psychiatric history) 6. pregnant or lactating women 7. participated in clinical trials of other drugs or medical devices within 3 months prior to enrollment

Keywords: minimal surgery spinal metastases invsasion-controlled surgery traditional-open surgery robot-assisted