Radiofrequency ablation and vertebral augmentation for palliation of painful spinal metastases

Wallace, Adam N.; Greenwood, Taylor J.; Jennings, Jack W.

doi:10.1007/s11060-015-1813-2

Cited by 96 publications

(89 citation statements)

References 24 publications

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“…The pathophysiology of pain relief caused by RFA is unclear. One explanation is that it reduces pain by destroying nociceptors as well as reducing the tumor burden [40]. Gevargez, et al [41] showed that 41 patients treated with RFA for vertebral metastases experienced a significant reduction in VAS scores within six weeks (p = .001) and continued to be significant at six months (p = 0.002).…”

Section: Reviewmentioning

confidence: 99%

“…Combining RFA and vertebroplasty provides a way to decrease tumor burden and retain or augment the supportive structure of the vertebral body. Wallace, et al [40] performed 72 RFA treatments with subsequent vertebroplasty in patients with spinal tumors. Patients treated with this combination of techniques experienced a significant decrease in VAS pain scores at one week and four weeks (median 3.25, 2.75, respectively; p < .0001).…”

Section: Reviewmentioning

confidence: 99%

“…Patients treated with this combination of techniques experienced a significant decrease in VAS pain scores at one week and four weeks (median 3.25, 2.75, respectively; p < .0001). Like vertebroplasty or kyphoplasty alone, RFA can result in almost immediate pain relief with a short recovery period [40]. Zheng, et al [43] showed similar results using RFA combined with kyphoplasty.…”

Section: Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors

Hariri

Takayanagi

Miulli

et al. 2017

Cureus

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Patients with metastatic spinal disease are affected by disabling pain. The treatment of spinal metastases is focused on pain reduction and improvement in quality of life. Until recently, many patients with metastatic spinal disease did not qualify as surgical candidates due to the risks of surgery and length of recovery period. However, recent advances in minimally invasive surgery such as kyphoplasty and vertebroplasty allow patients to safely undergo surgery for pain relief with a short recovery period.The studies reviewed here suggest that vertebral augmentation is successful in reducing pain and disability scores in patients with painful metastases and multiple myeloma and are a safe modality to provide lasting pain relief. As the use of kyphoplasty and vertebroplasty for treatment of vertebral metastases is becoming more common, new combinations of cement augmentation with other techniques such as percutaneous pedicle screws and radiofrequency ablation are being explored. The implementation of kyphoplasty and vertebroplasty, in conjunction with other minimally invasive surgical techniques as well as nonsurgical modalities, may lead to the best palliative management of cancer patients with spinal metastases and help them ultimately achieve a better quality of life.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors

Hariri

Takayanagi

Miulli

et al. 2017

Cureus

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“…9,10 The tandem procedure can be performed in an outpatient setting with the patient under conscious sedation, requires minimal recovery, and does not hinder or delay adjuvant therapies such as radiation or systemic chemotherapy. Multiple case series have shown decreased pain scores after RFA and vertebral augmentation of spinal metastases, [11][12][13][14][15] but evidence that percutaneous therapy achieves local tumor control is limited to case reports and small case series without internal controls. 13,14 The purpose of this study was to retrospectively evaluate the rate of radiographic local control of spinal metastases treated with combination RFA and vertebral augmentation at a National Cancer Institute-Designated Cancer Center.…”

mentioning

confidence: 99%

Radiographic Local Control of Spinal Metastases with Percutaneous Radiofrequency Ablation and Vertebral Augmentation

Wallace

Tomasian

Vaswani

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Combination radiofrequency ablation and vertebral augmentation is an emerging minimally invasive therapy for patients with metastatic spine disease who have not responded to or have contraindications to radiation therapy. The purpose of this study was to evaluate the rate of radiographic local control of spinal metastases treated with combination radiofrequency ablation and vertebral augmentation.

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confidence: 99%

Bipolar radiofrequency ablation for metastatic spinal tumors: an evolving paradigm in palliative care

Grasso

2015

J Neurooncol

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To the Editor, I read with great interest the article by Wallace and collaborators focusing on the combination of radiofrequency ablation (RFA) and vertebral augmentation for palliation of painful spinal metastases [1]. In a retrospective approach the authors reviewed a group of patients who underwent RFA for vertebral metastases in a period spanning almost 2 years. In a cohort of 110 patients, 72 RFA procedures were performed. Interestingly, 81 % of the metastatic lesions involved the posterior vertebral body and 45 % the pedicles. In almost all the cases, vertebral augmentation was performed following the ablation procedure.The authors found a significant decreased in pain scores at both 1-and 4-week follow-up. No major complications were reported nether symptomatic cement extravasation. They concluded that combination of RFA and vertebral augmentation is a safe and effective therapy for palliation of painful spinal metastases, including tumor involving the posterior vertebral body and/or pedicles.The authors are to be mentioned for describing this technique in more detail and presenting their series. Vertebral column is one of the most common sites of metastatic disease and frequent cause of chronic pain among cancer patients. In these cases a therapeutic approach should provide pain relief, improvement in mobility and quality of life. Accordingly, management of these patients is challenging and therapeutic potentials can include radiation, surgical therapy and systemic therapy. Many patients have a minimal or only brief response to traditional therapies and onset of pain relief can take months. Additionally, invasive surgical procedures are not indicated in these patient populations due to short expected lifespan and comorbidities. Surgery should be advocated in patients with progressive neurological deficits, instability requiring stabilization but if a relatively long life expectancy is strongly predicted.In this scenario, minimally invasive therapy options have blossomed in the last decades and among these thermal ablation in bone tumor followed by vertebral augmentation has offered the hope for a better control of the pain and valid improvement of the quality of life of patients with spinal metastasis.Although the data coming from the present study are encouraging some issues should be strictly considered. First, the indication for RFA and vertebral augmentation with respect to tumor localization and extension into the vertebral body. In this regard, the study by Wallace and collaborators report on a high percentage of patients with metastatic involvement of the posterior vertebral body and pedicles. It is well known that the use of RFA in the spine has traditionally been restricted to the anterior vertebral body due to the close proximity of tumor to neural tissues and limited treatment angle derived from the trans-or extra-pedicle approach of conventional RFA systems. In the present series the posterior wall lesion was easily accessed by the use of an articulating tumor ablation system (STAR, DFINE, San...

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Radiofrequency ablation and vertebral augmentation for palliation of painful spinal metastases

Cited by 96 publications

References 24 publications

Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors

Minimally Invasive Surgical Techniques for Management of Painful Metastatic and Primary Spinal Tumors

Radiographic Local Control of Spinal Metastases with Percutaneous Radiofrequency Ablation and Vertebral Augmentation

Bipolar radiofrequency ablation for metastatic spinal tumors: an evolving paradigm in palliative care

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