The Role of a Navigational Radiofrequency Ablation Device and Concurrent Vertebral Augmentation for Treatment of Difficult-to-Reach Spinal Metastases

Published on Oct 1, 2021in Current Oncology3.677
· DOI :10.3390/CURRONCOL28050340
Claudio Pusceddu9
Estimated H-index: 9
D. De Francesco + 2 AuthorsAlessandro Fancellu13
Estimated H-index: 13
Aims: The purpose of this study was to assess the effectiveness of a navigational radiofrequency ablation device with concurrent vertebral augmentation in the treatment of posterior vertebral body metastatic lesions, which are technically difficult to access. Primary outcomes of the study were evaluation of pain palliation and radiologic assessment of local tumor control. Materials and Methods: Thirty-five patients with 41 vertebral spinal metastases involving the posterior vertebral body underwent computed tomography-guided percutaneous targeted radiofrequency ablation, with a navigational radiofrequency ablation device, associated with vertebral augmentation. Twenty-one patients (60%) had 1 or 2 metastatic lesions (Group A) and fourteen (40%) patients had multiple (>2) vertebral lesions (Group B). Changes in pain severity were evaluated by visual analog scale (VAS). Metastatic lesions were evaluated in terms of radiological local control. Results: The procedure was technically successful in all the treated vertebrae. Among the symptomatic patients, the mean VAS score dropped from 5.7 (95% CI 4.9–6.5) before tRFA and to 0.9 (95% CI 0.4–1.3) after tRFA (p < 0.001). The mean decrease in VAS score between baseline and one week follow up was 4.8 (95% CI 4.2–5.4). VAS decrease over time between one week and one year following radiofrequency ablation was similar, suggesting that pain relief was immediate and durable. Neither patients with 1–2 vertebral metastases, nor those with multiple lesions, showed radiological signs of local progression or recurrence of the tumor in the index vertebrae during a median follow up of 19 months (4–46 months) and 10 months (4–37 months), respectively. Conclusion: Treatment of spinal metastases with a navigational radiofrequency ablation device and vertebral augmentation can be used to obtain local tumor control with immediate and durable pain relief, providing effective treatment in the multimodality management of difficult-to-reach spinal metastases.
#1Claudio PuscedduH-Index: 9
#2Giuseppe DessìH-Index: 2
Last. Ignazio SenisH-Index: 1
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Background and Objectives: The purpose of this study was to evaluate the feasibility, safety and efficacy of microwave ablation (MWA) in combination with open surgery nail positioning for the treatment of fractures or impending fractures of long bone metastases. Material and Methods: Eleven patients (four men, seven women) with painful bone metastases of the humerus, femur or tibia with non-displaced fractures (one case) or impending fractures (10 cases) underwent open MWA in combination with os...
#1Anderanik Tomasian (SC: University of Southern California)H-Index: 21
#2Jack W. Jennings (WashU: Washington University in St. Louis)H-Index: 15
AbstractMinimally invasive percutaneous thermal ablation of osseous metastases has proved safe and effective in management of selected patients with bone metastatic disease. These procedures have b...
#1Stergios BoussiosH-Index: 18
#2Deirdre CookeH-Index: 3
Last. Afroditi KarathanasiH-Index: 8
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: Malignant spinal cord compression (MSCC) is one of the most devastating complications of cancer. Patients often present with a history of progressive pain, paralysis, sensory loss, progressive spinal deformity, and loss of sphincter control. It is an emergency that requires rapid decision making on the part of several specialists, given the risk of permanent spinal cord injury or death. The goals of treatment in spinal metastases are pain control and improvement of neurological function in ord...
#1Anderanik Tomasian (SC: University of Southern California)H-Index: 21
#2Jack W. JenningsH-Index: 15
OBJECTIVE. The purpose of this article is to describe the use of a navigational bipolar radiofrequency ablation system for the treatment of spinal osteoid osteomas. CONCLUSION. Safe and effective i...
#1Domenica A. Delgado (Houston Methodist Hospital)H-Index: 8
#2Bradley S. Lambert (Houston Methodist Hospital)H-Index: 8
Last. Joshua D. HarrisH-Index: 58
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Background:The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between “no pain” and “worst pain.”Methods:One hundred consecutive patients aged ≥18 years who presente
#1M. DosaniH-Index: 1
#2S. LucasH-Index: 1
Last. Scott TyldesleyH-Index: 50
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Background The Spinal Instability Neoplastic Score (sins) was developed to identify patients with spinal metastases who may benefit from surgical consultation. We aimed to assess the distribution of sins in a population-based cohort of patients undergoing palliative spine radiotherapy (rt) and referral rates to spinal surgery pre-rt. Secondary outcomes included referral to a spine surgeon post-rt, overall survival, maintenance of ambulation, need for re-intervention, and presence of spinal adver...
#1Melinda Reyes (Point Loma Nazarene University)H-Index: 1
#2Mark M. Georgy (UCSD: University of California, San Diego)H-Index: 3
Last. Bassem A. Georgy (UCSD: University of California, San Diego)H-Index: 18
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Background Treatment of spinal metastatic lesions by radiofrequency ablation (RFA) before cementation can potentially help in local tumor control and pain relief. This is often limited by access and tumor location. This study reports multicenter clinical and imaging outcomes following targeted RFA (t-RFA) and cement augmentation in neoplastic lesions of the spine. Material and methods A retrospective multicenter study of 49 patients with 72 painful vertebral lesions, evaluated for clinical and i...
#1Anderanik Tomasian (SC: University of Southern California)H-Index: 21
#2Afshin GangiH-Index: 52
Last. Jack W. JenningsH-Index: 15
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OBJECTIVE. The purpose of this study was to review the available armamentarium and most recent advances in minimally invasive, image-guided percutaneous thermal ablation for treatment of spinal metastases. CONCLUSION. Minimally invasive percutaneous spine thermal ablation technologies have proved safe and effective in management of selected patients with spinal metastases. Special attention to procedure techniques including choice of ablation modality, thermoprotection, adequacy of treatment, an...
#1Malte MohmeH-Index: 14
#2Sabine RiethdorfH-Index: 67
Last. Sven O. EickerH-Index: 15
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Cement augmentation via percutaneous vertebroplasty or kyphoplasty for treatment of spinal metastasis is a well-established treatment option. We assessed whether elevated intrametastatic pressure during cement augmentation results in an increased dissemination of tumour cells into the vascular circulation. We prospectively collected blood from patients with osteolytic spinal column metastases and analysed the prevalence of circulating tumour cells (CTCs) at three time-points: preoperatively, 20 ...
#1Ping‑Lin Yang (Xi'an Jiaotong University)H-Index: 1
#2Xijing He (Xi'an Jiaotong University)H-Index: 26
Last. Guo‑Yu Wang (Xi'an Jiaotong University)H-Index: 1
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: In order to provide effective options for minimally invasive treatment of spinal metastases, the present study retrospectively evaluated the efficacy and safety of image-guided minimally invasive percutaneous treatment of spinal metastases. Image-guided percutaneous vertebral body enhancement, radiofrequency ablation (RFA) and tumor debulking combined with other methods to strengthen the vertebrae were applied dependent on the indications. Percutaneous vertebroplasty (PVP) was used when verteb...
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