{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:15:07Z","timestamp":1784333707336,"version":"3.55.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Severe lytic cancerous lesions of the spine are associated with significant morbidity and treatment challenges. Stabilization and restoration of the axial load capability of the vertebral body (VB) are important to prevent or arrest vertebral collapse. Percutaneous stent screw\u2013assisted internal fixation (SAIF), which anchors a VB stent\/cement complex with pedicular screws to the posterior vertebral elements, is a minimally invasive, image-guided, 360\u00b0 internal fixation technique that can be utilized in this patient cohort. The purpose of this study was to assess the feasibility, safety, and stabilization efficacy of VB reconstruction via the SAIF technique in a cohort of patients with extensive lytic vertebral lesions, who were considered to have an unstable or potentially unstable spine according to the Spinal Instability Neoplastic Score (SINS).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This study was a retrospective assessment of a prospectively maintained database of a consecutive series of patients with neoplastic extensive extracompartmental osteolysis (Tomita type 4\u20136) of the VB treated with the SAIF technique. VB reconstruction was assessed on postprocedure plain radiographs and CT by two independent raters. Technical and clinical complications were recorded. Clinical and imaging follow-ups were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Thirty-five patients with extensive osteolytic metastatic lesions of the VB underwent 36 SAIF procedures. SAIF was performed as a stand-alone procedure in 31\/36 cases and was associated with posterior surgical fixation in 5\/36 (4\/5 with decompressive laminectomy). In 1 case an epidural cement leak required surgical decompression. VB reconstruction was categorized as satisfactory (excellent or good rating) by the two raters in 34\/36 cases (94.5%) with an interrater reliability of 94.4% (Cohen\u2019s kappa of 0.8). Follow-up, ranging from 1 to 30 months, was available for 30\/36 levels. Long-term follow-up (6\u201330 months, mean 11.5 months) was available for 16\/36 levels. Stability during follow-up was noted in 29\/30 cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>SAIF provides 360\u00b0 nonfusion internal fixation that stabilizes the VB in patients with extensive lytic lesions that would otherwise be challenging to treat.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.9.spine19711","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T22:45:17Z","timestamp":1576881917000},"page":"507-518","source":"Crossref","is-referenced-by-count":12,"title":["Stent screw\u2013assisted internal fixation (SAIF): clinical report of a novel approach to stabilizing and internally fixating vertebrae destroyed by malignancy"],"prefix":"10.3171","volume":"32","author":[{"given":"Alessandro","family":"Cianfoni","sequence":"first","affiliation":[{"name":"Department of Neuroradiology, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano;"},{"name":"Department of Interventional and Diagnostic Neuroradiology, Inselspital University Hospital of Bern;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Distefano","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Scarone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco A.","family":"Pesce","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Espeli","sequence":"additional","affiliation":[{"name":"Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, San Giovanni, Bellinzona, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"La Barbera","sequence":"additional","affiliation":[{"name":"Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering \u201cGiulio Natta\u201d, Politecnico di Milano, Milan, Italy;"},{"name":"Department of Mechanical Engineering, Polytechnique Montr\u00e9al;"},{"name":"Sainte-Justine Clinical Hospital Center, Montr\u00e9al, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomaso","family":"Villa","sequence":"additional","affiliation":[{"name":"Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering \u201cGiulio Natta\u201d, Politecnico di Milano, Milan, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Reinert","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano;"},{"name":"Department of Neurosurgery, Inselspital University Hospital of Bern, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Bonaldi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Igea Clinic, Milan, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"(Suppl 20","key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S254","DOI":"10.1097\/BRS.0000000000001819","article-title":"Evidence-based review and survey of expert opinion of reconstruction of metastatic spine tumors","volume":"41","author":"Altaf F","year":"2016","unstructured":"Altaf F, Weber M, Dea N, Boriani S, Ames C, Williams R, : Evidence-based review and survey of expert opinion of reconstruction of metastatic spine tumors. 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