Spinal Laser Interstitial Thermal Therapy for Metastatic Tumors

Spinal laser interstitial thermal therapy (sLITT) is a novel minimally invasive therapeutic modality for the treatment of metastatic epidural spinal cord tumors. When used in conjunction to spinal stereotactic radiosurgery (SSRS), it can provide effective and durable local control with minimal morbidity. This approach is ideally suited for patients who are poor candidates for large-scale oncologic spinal surgery and can act synergistically with SSRS, maximize local control, and palliate pain. Compared to other percutaneous techniques, sLITT is unique in offering real-time monitoring of thermal injury with use of an intraoperative MRI. Additional benefits over conventional separation surgery include shortened hospital admissions, minimal postprocedure pain, and minimal blood loss. Furthermore, vascular tumors do not require preoperative embolization, and patients with significant medical comorbidities can usually tolerate the procedure. Moreover, individuals who need continued systemic therapy can safely be treated without interruption in chemotherapy. The technology is still early in its development but combined with radiosurgery has the promise to provide effective oncologic control with minimal procedural morbidity.