Advances in the clinical research of the minimally invasive treatment for the posterior edge of vertebral-body defects by spinal metastases

Liu, Xuefeng; Yang, Zuozhang; Xie, Lin; Yuan, Zongqin; Ren, Mingyan; Han, Lei

doi:10.3892/br.2015.483

Cited by 8 publications

(8 citation statements)

References 37 publications

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“…RFA can also cause intravertebral venous plexus thrombosis, and subsequently reduce the risk of PMM leakage. Liu et al reported that the combination of RFA, a minimally invasive intervention used for treating metastatic spine lesions, with percutaneous VP was particularly beneficial in reducing the incidence of fracture, risk of pain and surgery, and improving the QoL [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Role of radiofrequency ablation and cement injection for pain control in patients with spinal metastasis

Yıldızhan

Boyacı

Rakip

et al. 2021

BMC Musculoskelet Disord

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Background The study aimed to investigate the effects and reliability of simultaneous vertebroplasty and radiofrequency ablation or radiofrequency ablation applied alone for pain control in patients with painful spine metastasis, and to investigate the effect of preventing tumor spread in long-term follow-up. Methods Patients with painful vertebrae metastasis in the Afyonkarahisar Health Sciences University, Medical Faculty, Hospital Neurosurgery Clinic between 01.01.2015 and 01.06.2020 were recruited. They were divided into groups according to the surgical procedures applied. Group 1 included 26 patients who underwent radiofrequency ablation only, and group 2 included 40 patients who underwent vertebroplasty with radiofrequency ablation. Computed tomography and magnetic resonance imaging were performed in all patients pre-operation. The patients were followed for at least 6 months. Magnetic resonance imaging was performed at the end of the 6th month in neurologically stable patients. The metastatic lesion, pain, and quality of life were evaluated with Visual Analog Scale and Oswestry Disability Survey before and after the procedure. Results The mean VAS score before the procedure was 8.3 ± 1.07 in the RFA group, and a statistically significant difference was observed in VAS scores at all post-procedural measurement time-points (p < 0.001). The pain scores decreased at a rate of 58.8 and 69.6% of patients showed significant improvements in the QoL in the RFA-only group. The mean VAS score was 7.44 ± 1.06 in group RFA + VP before the procedure; the difference in the mean VAS scores was statistically significant at all measurement time-points after the procedure (p < 0.001). The mean pre-treatment Oswestry Index (to assess the QoL) was 78.50% in the RFA + VP group, which improved to 14.2% after treatment. Conclusion Ablation + vertebroplasty performed to control palliative pain and prevent tumor spread in patients with painful vertebral metastasis is more successful than vertebroplasty performed alone.

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Section: Discussionmentioning

confidence: 99%

Role of radiofrequency ablation and cement injection for pain control in patients with spinal metastasis

Yıldızhan

Boyacı

Rakip

et al. 2021

BMC Musculoskelet Disord

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“…Metastatic lesions that spread to the spine can cause severe pain, spinal fractures, and neurological problems due to nerve root and spine compression by the tumour mass [7]. Several treatment alternatives for spinal metastases including radiotherapy, chemotherapy, isotopic therapy, bisphosphonate therapy, pharmacotherapy, RFA, and palliative surgery can be used [8].…”

Section: Discussionmentioning

confidence: 99%

“…RFA can also cause intravertebral venous plexus thrombosis, and subsequently reduce the risk of PMM leakage. Liu et al reported that the combination of RFA, a minimally invasive intervention used for treating metastatic spine lesions, with percutaneous VP was particularly bene cial in reducing the incidence of fracture, risk of pain and surgery, and improving the QoL [7].…”

Section: Discussionmentioning

confidence: 99%

“…The most common tumours that metastasize to the spine include lung, breast, kidney, prostate, thyroid, and colorectal cancers and melanomas, myelomas, and lymphomas [5,6]. The metastatic spread of tumours to the spine causes serious neurological problems arising from severe pain, spinal fractures, and compression of the nerve roots and spine by the lesion mass [7]. Radiotherapy, chemotherapy, isotopic therapy, bisphosphonate therapy, pharmacotherapy, radiofrequency ablation (RFA), and palliative surgery may be used for the treatment of spinal metastases [8].…”

Section: Introductionmentioning

confidence: 99%

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Role of Radiofrequency Ablation and Cement Injection for Pain Control in Patients with Spinal Metastasis

Yıldızhan

Boyacı

Rakip

et al. 2021

Preprint

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Purpose The study aimed to investigate the effects and reliability in the prevention of tumour spread of radiofrequency ablation or ablation with vertebroplasty simultaneously applied for pain in patients with painful spinal vertebra metastasis and the effect of preventing tumor spread in long-term follow-up. Methods Patients with painful vertebrae metastasis in the XXX Health Sciences University, Medical Faculty, Hospital Neurosurgery Clinic between 01.01.2015 and 01.02.2019 were recruited. They were divided into groups according to the surgical procedures applied. Group 1 included 12 patients who underwent radiofrequency ablation only, and group 2 included 16 patients who underwent vertebroplasty with radiofrequency ablation. The metastatic lesion, pain, and quality of life were evaluated with imaging, Visual Analog Scale, and Oswestry Disability Survey before and after the procedure. Results A total of 28 patients diagnosed with painful spinal metastasis were included in our study. The degree of collapse increased in five patients in group 1, leading to vertebroplasty. Simple polymethyl methacrylate leakage was observed in four patients in group 2 without spinal cord compression. Pain and quality of life improved significantly in both groups, with more being in Group 2, and analgesic use was significantly reduced. No tumor spread in the vertebrae was observed in any patient during follow-up. Conclusion According to our results, patients with painful vertebral metastases should receive vertebroplasty simultaneously with radiofrequency ablation for palliative pain control and prevention of tumour spread.

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“…Radiofrequency ablation (RFA) was initially developed in the past few decades for treatment of soft tissue tumors and has been proved to be a safe and effective therapeutic option for patients with liver, lung, kidney and bone neoplasms and has been increasingly performed in clinical settings [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] . Ever since the first application of RFA in the bone tissue for treating osteoid osteoma was reported in 1992 [11] , this technique has been employed for more bone tumors including chondroblastoma [12] , chondromas [13] , and osteolytic metastasis [14] .…”

Section: Introductionmentioning

confidence: 99%

Thermal effect of percutaneous radiofrequency ablation with a clustered electrode for vertebral tumors: In vitro and vivo experiments and clinical application

Zhao

Peng

Chen

et al. 2018

Journal of Bone Oncology

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PurposeTo investigate effects and heat distribution of radiofrequency ablation (RFA) on vertebral tumors in vitro and in vivo swine experiments and its clinical application.Materials and methodsRFA was performed on the swine spine in vitro and in vivo for 20 min at 90 °C at the electrode tip, and the temperature at the electrode tip and surrounding tissues were recorded. Clinical application of ablation combined with vertebroplasty was subsequently performed in 4 patients with spinal tumors.ResultsIn the in vitro study, the mean temperature at the front and ventral wall of the spinal canal was 50.8 °C and 43.6 °C, respectively, at 20 mm significantly greater than 37.7 °C and 33.7 ± 1.7 °C, respectively, at 10 mm ablation depth. The coagulative necrosis area was significantly (P < 0.0001) greater at 20 mm depth than at 10 mm depth (mean 17.0 × 20.7 mm2 vs. 14.2 × 16.6 mm2). In the in vivo experiment, the local temperature increased significantly (P < 0.05) from around 36 °C before ablation to over 41 °C at 20 min after ablation, with the temperature at the electrode tip (90.4 °C) and within the vertebral body (67.0 °C) significantly (P < 0.05) greater than at the posterior (41.9 °C) and lateral wall (41.8 °C). From 2 to 5 weeks, bone remodeling began. Clinically, all four patients had successful RFA and vertebroplasty, with no neurological deficits. The pain scores were significanlty (P < 0.05) improved before (4.5–10, mean 8.0) compared with at four weeks (0–1.8, mean 1.8).ConclusionThe clustered electrode can be efficiently and safely applied in the treatment of spinal tumors without damaging the spinal cord and adjacent nerves by heat distribution.

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Advances in the clinical research of the minimally invasive treatment for the posterior edge of vertebral-body defects by spinal metastases

Cited by 8 publications

References 37 publications

Role of radiofrequency ablation and cement injection for pain control in patients with spinal metastasis

Role of radiofrequency ablation and cement injection for pain control in patients with spinal metastasis

Role of Radiofrequency Ablation and Cement Injection for Pain Control in Patients with Spinal Metastasis

Thermal effect of percutaneous radiofrequency ablation with a clustered electrode for vertebral tumors: In vitro and vivo experiments and clinical application

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