Using Endoscopic Approaches in the Surgical Management of Spinal Metastatic Disease

Patients with spinal metastasis often benefit from surgical intervention for debulking to improve neurologic deficits, reduce spinal cord or root compression, and ameliorate pain. Traditionally, large, open fusions have been used to achieve adequate decompression of neural structures. These types of interventions are frequently associated with significant blood loss, prolonged hospitalizations, and increased risk of surgery-related complications, which can delay postoperative chemotherapy and radiation therapies. Endoscopic spine approaches allow access to the spinal cord and nerve roots with minimal soft tissue disruption, which has been shown to reduce risks associated with open surgery in other contexts. Furthermore, the smaller incision, reduced blood loss, ability to position incisions away from radiation fields, and lower risk profile in high-risk patients may provide an effective solution to spinal metastases in appropriately selected cases. Here, we present two cases of spinal metastases successfully managed with spinal endoscopy and recommend the consideration of this approach for similar scenarios.