{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:21:46Z","timestamp":1786947706626,"version":"build-2736575974"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,10]]},"abstract":"\n OBJECTIVE<\/jats:title>\n An emerging paradigm for treating patients with epidural spinal cord compression (ESCC) caused by metastatic tumors is surgical decompression and stabilization, followed by stereotactic radiosurgery. In the setting of rapid progressive disease, interruption or delay in return to systemic treatment can lead to a negative impact in overall survival. To overcome this limitation, the authors introduce the use of spinal laser interstitial thermotherapy (sLITT) in association with percutaneous spinal stabilization to facilitate a rapid return to oncological treatment.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors retrospectively reviewed a consecutive series of patients with ESCC and spinal instability who were considered to be poor surgical candidates and instead were treated with sLITT and percutaneous spinal stabilization. Demographic data, Spine Instability Neoplastic Scale score, degree of epidural compression before and after the procedure, length of hospital stay, and time to return to oncological treatment were analyzed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Eight patients were treated with thermal ablation and percutaneous spinal stabilization. The primary tumors included melanoma (n = 3), lung (n = 3), thyroid (n = 1), and renal cell carcinoma (n = 1). The median Karnofsky Performance Scale score before and after the procedure was 60, and the median hospital stay was 5 days (range 3\u201318 days). The median Spine Instability Neoplastic Scale score was 13 (range 12\u201316). The mean modified postoperative ESCC score (2.75 \u00b1 0.37) was significantly lower than the preoperative score (4.5 \u00b1 0.27) (Mann-Whitney test, p = 0.0044). The median time to return to oncological treatment was 5 days (range 3\u201310 days).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The authors present the first cohort of sLITT associated with a percutaneous spinal stabilization for the treatment of ESCC and spinal instability. This minimally invasive technique can allow a faster recovery without prejudice of adjuvant systemic treatment, with adequate local control and spinal stabilization.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.8.focus16175","type":"journal-article","created":{"date-parts":[[2016,10,1]],"date-time":"2016-10-01T03:37:26Z","timestamp":1475293046000},"page":"E2","source":"Crossref","is-referenced-by-count":21,"title":["Percutaneous surgery for treatment of epidural spinal cord compression and spinal instability: technical note"],"prefix":"10.3171","volume":"41","author":[{"given":"Claudio E.","family":"Tatsui","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Telmo A. B.","family":"Belsuzarri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Catholic University of Campinas, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilou","family":"Oro","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence D.","family":"Rhines","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Radiation Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amol J.","family":"Ghia","sequence":"additional","affiliation":[{"name":"Radiation Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behrang","family":"Amini","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heron","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Radiation Oncology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Rao","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16175","series-title":"Hematol Oncol Clin North Am","first-page":"1307","article-title":"Surgical approach to epidural spinal cord compression","volume":"20","author":"Bilsky","year":"2006"},{"key":"b2-focus16175","series-title":"J Neurosurg Spine","first-page":"324","article-title":"Reliability analysis of the epidural spinal cord compression scale","volume":"13","author":"Bilsky","year":"2010"},{"key":"b3-focus16175","series-title":"J Neurosurg Spine","first-page":"151","article-title":"Phase I\/II study of stereotactic body radiotherapy for spinal metastasis and its pattern of failure","volume":"7","author":"Chang","year":"2007"},{"key":"b4-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"E1221","article-title":"A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group","volume":"35","author":"Fisher","year":"2010"},{"key":"b5-focus16175","series-title":"Paraplegia","first-page":"179","article-title":"The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I","volume":"7","author":"Frankel","year":"1969"},{"key":"b6-focus16175","series-title":"J Neurosurg Spine","first-page":"288","article-title":"Stereotactic radiosurgery for spinal metastases from renal cell carcinoma","volume":"3","author":"Gerszten","year":"2005"},{"key":"b7-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"193","article-title":"Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution","volume":"32","author":"Gerszten","year":"2007"},{"issue":"22 Suppl","key":"b8-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"S78","article-title":"Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes?","volume":"34","author":"Gerszten","year":"2009"},{"key":"b9-focus16175","series-title":"Pract Radiat Oncol","first-page":"e35","article-title":"The use of image guided laser interstitial thermotherapy to supplement spine stereotactic radiosurgery to manage metastatic epidural spinal cord compression: Proof of concept and dosimetric analysis.","volume":"6","author":"Ghia","year":"2016"},{"issue":"2","key":"b10-focus16175","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Percutaneous techniques for minimally invasive posterior lumbar fusion","volume":"25","author":"Harris","year":"2008"},{"key":"b11-focus16175","series-title":"Radiother Oncol","first-page":"227","article-title":"Role of radiotherapy in metastatic spinal cord compression: preliminary results from a prospective trial","volume":"15","author":"Latini","year":"1989"},{"key":"b12-focus16175","series-title":"J Neurosurg Spine","first-page":"207","article-title":"Local disease control for spinal metastases following \u201cseparation surgery\u201d and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients","volume":"18","author":"Laufer","year":"2013"},{"key":"b13-focus16175","series-title":"Oncologist","first-page":"744","article-title":"The NOMS framework: approach to the treatment of spinal metastatic tumors","volume":"18","author":"Laufer","year":"2013"},{"key":"b14-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"959","article-title":"Effectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial","volume":"32","author":"Maranzano","year":"1995"},{"key":"b15-focus16175","series-title":"Spine J","first-page":"1609","article-title":"Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability","volume":"15","author":"Moussazadeh","year":"2015"},{"key":"b16-focus16175","series-title":"Lancet","first-page":"643","article-title":"Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial","volume":"366","author":"Patchell","year":"2005"},{"key":"b17-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1160","article-title":"Role of radiotherapy in the treatment of motor dysfunction due to metastatic spinal cord compression: comparison of three different fractionation schedules","volume":"54","author":"Rades","year":"2002"},{"key":"b18-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"514","article-title":"Comparison of 1 \u00d7 8 Gy and 10 \u00d7 3 Gy for functional outcome in patients with metastatic spinal cord compression","volume":"62","author":"Rades","year":"2005"},{"key":"b19-focus16175","series-title":"Radiat Oncol J","first-page":"1","article-title":"Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015","volume":"33","author":"Ryu","year":"2015"},{"key":"b20-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"652","article-title":"Stereotactic body radiosurgery for spinal metastases: a critical review","volume":"71","author":"Sahgal","year":"2008"},{"key":"b21-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"341","article-title":"Probabilities of radiation myelopathy specific to stereotactic body radiation therapy to guide safe practice","volume":"85","author":"Sahgal","year":"2013"},{"key":"b22-focus16175","series-title":"J Neurosurg Spine","first-page":"400","article-title":"Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis","volume":"23","author":"Tatsui","year":"2015"},{"key":"b23-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"69","article-title":"Outcome of treatment for spinal metastases using scoring system for preoperative evaluation of prognosis","volume":"34","author":"Tokuhashi","year":"2009"},{"key":"b24-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"2186","article-title":"A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis","volume":"30","author":"Tokuhashi","year":"2005"},{"key":"b25-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"298","article-title":"Surgical strategy for spinal metastases","volume":"26","author":"Tomita","year":"2001"},{"key":"b26-focus16175","series-title":"Lancet Oncol","first-page":"395","article-title":"Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1\u20132 trial","volume":"13","author":"Wang","year":"2012"},{"key":"b27-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"484","article-title":"High-dose, single-fraction image-guided intensity-modulated radiotherapy for metastatic spinal lesions","volume":"71","author":"Yamada","year":"2008"},{"key":"b1-focus16175","series-title":"Hematol Oncol Clin North Am","first-page":"1307","article-title":"Surgical approach to epidural spinal cord compression","volume":"20","author":"Bilsky","year":"2006"},{"key":"b2-focus16175","series-title":"J Neurosurg Spine","first-page":"324","article-title":"Reliability analysis of the epidural spinal cord compression scale","volume":"13","author":"Bilsky","year":"2010"},{"key":"b3-focus16175","series-title":"J Neurosurg Spine","first-page":"151","article-title":"Phase I\/II study of stereotactic body radiotherapy for spinal metastasis and its pattern of failure","volume":"7","author":"Chang","year":"2007"},{"key":"b4-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"E1221","article-title":"A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group","volume":"35","author":"Fisher","year":"2010"},{"key":"b5-focus16175","series-title":"Paraplegia","first-page":"179","article-title":"The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. 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metastatic epidural spinal cord compression: Proof of concept and dosimetric analysis.","volume":"6","author":"Ghia","year":"2016"},{"issue":"2","key":"b10-focus16175","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Percutaneous techniques for minimally invasive posterior lumbar fusion","volume":"25","author":"Harris","year":"2008"},{"key":"b11-focus16175","series-title":"Radiother Oncol","first-page":"227","article-title":"Role of radiotherapy in metastatic spinal cord compression: preliminary results from a prospective trial","volume":"15","author":"Latini","year":"1989"},{"key":"b12-focus16175","series-title":"J Neurosurg Spine","first-page":"207","article-title":"Local disease control for spinal metastases following \u201cseparation surgery\u201d and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients","volume":"18","author":"Laufer","year":"2013"},{"key":"b13-focus16175","series-title":"Oncologist","first-page":"744","article-title":"The NOMS framework: approach to the treatment of spinal metastatic tumors","volume":"18","author":"Laufer","year":"2013"},{"key":"b14-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"959","article-title":"Effectiveness of radiation therapy without surgery in metastatic spinal cord compression: final results from a prospective trial","volume":"32","author":"Maranzano","year":"1995"},{"key":"b15-focus16175","series-title":"Spine J","first-page":"1609","article-title":"Short-segment percutaneous pedicle screw fixation with cement augmentation for tumor-induced spinal instability","volume":"15","author":"Moussazadeh","year":"2015"},{"key":"b16-focus16175","series-title":"Lancet","first-page":"643","article-title":"Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial","volume":"366","author":"Patchell","year":"2005"},{"key":"b17-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1160","article-title":"Role of radiotherapy in the treatment of motor dysfunction due to metastatic spinal cord compression: comparison of three different fractionation schedules","volume":"54","author":"Rades","year":"2002"},{"key":"b18-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"514","article-title":"Comparison of 1 \u00d7 8 Gy and 10 \u00d7 3 Gy for functional outcome in patients with metastatic spinal cord compression","volume":"62","author":"Rades","year":"2005"},{"key":"b19-focus16175","series-title":"Radiat Oncol J","first-page":"1","article-title":"Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015","volume":"33","author":"Ryu","year":"2015"},{"key":"b20-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"652","article-title":"Stereotactic body radiosurgery for spinal metastases: a critical review","volume":"71","author":"Sahgal","year":"2008"},{"key":"b21-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"341","article-title":"Probabilities of radiation myelopathy specific to stereotactic body radiation therapy to guide safe practice","volume":"85","author":"Sahgal","year":"2013"},{"key":"b22-focus16175","series-title":"J Neurosurg Spine","first-page":"400","article-title":"Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis","volume":"23","author":"Tatsui","year":"2015"},{"key":"b23-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"69","article-title":"Outcome of treatment for spinal metastases using scoring system for preoperative evaluation of prognosis","volume":"34","author":"Tokuhashi","year":"2009"},{"key":"b24-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"2186","article-title":"A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis","volume":"30","author":"Tokuhashi","year":"2005"},{"key":"b25-focus16175","series-title":"Spine (Phila Pa 1976)","first-page":"298","article-title":"Surgical strategy for spinal metastases","volume":"26","author":"Tomita","year":"2001"},{"key":"b26-focus16175","series-title":"Lancet Oncol","first-page":"395","article-title":"Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1\u20132 trial","volume":"13","author":"Wang","year":"2012"},{"key":"b27-focus16175","series-title":"Int J Radiat Oncol Biol Phys","first-page":"484","article-title":"High-dose, single-fraction image-guided intensity-modulated radiotherapy for metastatic spinal 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Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/41\/4\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/41\/4\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/41\/4\/article-pE2.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T08:59:46Z","timestamp":1779526786000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/41\/4\/article-pE2.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10]]},"references-count":54,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2016.8.focus16175","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10]]}}}