Palliative Surgery for Metastatic Spinal Tumor Using an Ultrasonic Osteotome : A Report of Four Cases

Abstract

Various surgical techniques for spinal metastases have been described. Although curative surgery such as total en bloc spondylectomy for spinal metastases has been advocated, such an aggressive approach is not always justified in patients predicted to have short survival. For patients with limited life expectancy, palliative surgery such as posterior decompression with stabilization is often selected. Recently, many authors have reported an excision technique employing an ultrasonic osteotome. We have performed posterolateral circumspinal decompression with an ultrasonic osteotome, and anterior vertebral reconstruction using cement augmentation and posterior fusion for four patients with thoracolumbar spinal metastases. Pain relief and improvement of paresis were obtained in all cases. This technique is relatively safe and less invasive for short-term palliation.