{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:34:08Z","timestamp":1784565248023,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T00:00:00Z","timestamp":1409529600000},"content-version":"vor","delay-in-days":31,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Surgical treatment of spinal metastasis is generally a palliative procedure. Although minimally invasive surgical (<jats:styled-content style=\"fixed-case\">MIS<\/jats:styled-content>) techniques are supposedly less morbid than open techniques, there is a lack of stratification of <jats:styled-content style=\"fixed-case\">MIS<\/jats:styled-content> techniques based on anticipated longevity. A simple stratification into three percutaneous surgical techniques based on modified Tokuhashi score is here proposed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients recommended for spinal surgery for metastatic spinal disease between 2009 and 2012 and operated on by the senior author (<jats:styled-content style=\"fixed-case\">RJM<\/jats:styled-content>) were retrospectively reviewed. One of three <jats:styled-content style=\"fixed-case\">MIS<\/jats:styled-content> techniques was offered based on estimated survival using a modified Tokuhashi score. Technique #1 is suitable for patients with predicted short longevity (&lt;6 months). Using a mini\u2010open midline or paramedian decompression and percutaneous screw fixation, the goal here is for rapid mobilization and minimization of hospitalization. Technique #2 is suitable for patients with predicted medium longevity (6\u201312 months). They are suitable for decompression and\/or cement vertebral body replacement and a two levels stabilization. Technique #3 is suitable for patients with predicted long term survival survival (&gt;12 months). In these patients, the primary goal of surgery is a wide local or marginal resection of tumor, decompression of the neurological elements and a robust stabilization construct. They are suitable for an open 360\u00b0decompression, vertebral body reconstruction and a multilevel stabilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included eight patients with a mean age of 59 years (range, 36\u201372 years). Mean modified Tokuhashi score was 10 (range, 7\u201313) with three patients in the short term, two in the medium term and three in the long term survival category. Mean blood loss was 700\u2009mL (range, 100\u20131200\u2009mL), mean operating time 280\u2009min (range, 120\u2013360\u2009min) and length of stay in the hospital was on average 13 days (range, 3\u201330 days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The authors present three minimally invasive technique options for the management of spinal metastatic disease corresponding to three clinical prognostic categories. In this small series, <jats:styled-content style=\"fixed-case\">MIS<\/jats:styled-content> techniques resulted in speedy recovery, minimal morbidity and no mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12114","type":"journal-article","created":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T12:26:12Z","timestamp":1409574372000},"page":"187-195","source":"Crossref","is-referenced-by-count":54,"title":["Minimally Invasive Percutaneous Fixation Techniques for Metastatic Spinal Disease"],"prefix":"10.1111","volume":"6","author":[{"given":"Prashanth J.","family":"Rao","sequence":"first","affiliation":[{"name":"Neurospine Clinic Prince of Wales Hospital  Sydney Australia"},{"name":"University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesha K.","family":"Thayaparan","sequence":"additional","affiliation":[{"name":"Neurospine Clinic Prince of Wales Hospital  Sydney Australia"},{"name":"University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M.","family":"Fairhall","sequence":"additional","affiliation":[{"name":"Neurospine Clinic Prince of Wales Hospital  Sydney Australia"},{"name":"University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph J.","family":"Mobbs","sequence":"additional","affiliation":[{"name":"Neurospine Clinic Prince of Wales Hospital  Sydney Australia"},{"name":"University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(98)00288-0"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199001000-00001"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193101000-00036"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2006.11.002"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000180401.06919.a5"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B7.14201"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-008-0012-0"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66954-1"},{"key":"e_1_2_5_10_1","first-page":"265","article-title":"Spinal metastases: treatment evaluation algorithm","volume":"8","author":"Gasbarrini A","year":"2004","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2008.09.002"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200102010-00016"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/SPI\/2008\/8\/3\/271"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2004.1.3.0287"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1085-9489.2005.0010206.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1867-6"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2007.04.002"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2011.10.004"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000363600.24074.D0"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31823c80d8"},{"key":"e_1_2_5_21_1","first-page":"598148","article-title":"A systematic review of the current role of minimally invasive spine surgery in the management of metastatic spine disease","volume":"2011","author":"Molina CA","year":"2011","journal-title":"Int J Surg Oncol"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.4.SPINE111108"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.4.0565"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2012.12.016"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-1894-x"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000225995.56028.46"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900987"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1054\/jocn.2001.1064"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.3171\/FOC\/2008\/25\/8\/E8"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005860100281"},{"issue":"1","key":"e_1_2_5_31_1","first-page":"S161","article-title":"Minimally invasive retroperitoneal approach for lumbar corpectomy and anterior reconstruction. 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