The effect of pre-vertebroplasty tumor ablation using laser-induced thermotherapy on biomechanical stability and cement fill in the metastatic spine

Ahn, Henry; Mousavi, Payam; Chin, Lee; Roth, Sandra E.; Finkelstein, Joel; Vitken, Alex; Whyne, Cari

doi:10.1007/s00586-007-0375-1

Cited by 27 publications

(34 citation statements)

References 33 publications

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“…25 Cavity creation in the vertebral body was performed with Coblation Wands (Fig 2), as previously reported by other authors, 19,26,27 in 59/70 levels. The decision not to use Coblation was made intraprocedurally when the advancement of the trocar cannulas through the lytic area did not reveal typical softtissue consistency, but rather fluid consistency, such as in markedly necrotic tumors or in some multiple myeloma lesions.…”

Section: Cavity Creationmentioning

confidence: 99%

Vertebral Augmentation for Neoplastic Lesions with Posterior Wall Erosion and Epidural Mass

Cianfoni¹,

Raz

Mauri

et al. 2014

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:The presence of a cortical erosion of the posterior wall or an epidural mass is commonly considered a contraindication to performing a vertebral augmentation, considering the perceived increased risk of an epidural cement leak. Our aim was to assess technical and clinical complications of vertebral augmentation procedures performed for pain palliation and/or stabilization of neoplastic lytic vertebral body lesions, with cortical erosion of the posterior wall, often associated with a soft-tissue epidural mass.

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Section: Cavity Creationmentioning

confidence: 99%

Vertebral Augmentation for Neoplastic Lesions with Posterior Wall Erosion and Epidural Mass

Cianfoni¹,

Raz

Mauri

et al. 2014

American Journal of Neuroradiology

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“…The chosen flow rate was similar to that reported in previous cadaveric studies [30,31] and falls within the range reported during clinical percutaneous vertebroplasty (PV) which is 1.2 to 12.0 mL/min [32]. However, in clinical PV intermittent injections are typically performed with pauses due to changing of syringes and/or the needle position, which is often retracted backwards due to excessive pressurization [32].…”

Section: Discussionmentioning

confidence: 60%

Novel methodology for assessing biomaterial–biofluid interaction in cancellous bone

Bou-Francis

Soyka

Ferguson

et al. 2015

Journal of the Mechanical Behavior of Biomedical Materials

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“…The following year, Ahn et al 33 confirmed the FEA model of Tshirchart et al 32 in cadaveric tissue. Using laser-induced thermotherapy (LITT) to ablate the tumor immediately before vertebroplasty-facilitated bone cement placement improved biomechanical stability and reduced the risk of cement extravasation over using the vertebroplasty procedure alone.…”

Section: Tumor Debulking Combined With Vertebral Body Augmentationmentioning

confidence: 77%

Metastatic Spinal Lesions: State-of-the-Art Treatment Options and Future Trends

Georgy¹

2008

AJNR Am J Neuroradiol

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SUMMARY:The purpose of this article is to review the current state of the art for treating symptomatic spinal fractures associated with malignant lesions and to present potential future trends in treatments for this patient population. Epidemiology, clinical presentation, and biomechanical ramifications of these lesions are summarized and treatment regimes, clinical outcomes, and complications and technical issues associated with treatments are presented. Potential future trends and new technologies for performing vertebral body augmentation in patients with metastatic spinal lesions are also discussed. Metastatic bone tumors in the spine are painful and debilitating but are challenging to treat and often require relatively extensive surgery, which many clinicians and patients are reluctant to pursue. Percutaneous approaches for performing vertebral body augmentation for treating metastatic spinal lesions have been developed as good alternatives to open surgery. These types of procedures have evolved immensely over the last 10 years, and the current state of the art has been found to fit neatly into the conventional oncologic treatment algorithm. Epidemiology and Clinical PresentationSpinal metastasis is the most commonly encountered tumor of the spine, 1 occurring in Յ40% of patients with cancer. 2 Each year, 5% of patients with cancer, or approximately 61,000 persons, will develop spinal metastasis. 3 The cancers most often metastasizing to the spine include breast (21%), lung (14%), prostate (8%), renal (5%), gastrointestinal (5%), and thyroid (3%). Two of 3 patients are affected in the thoracic spine, whereas affected areas of the other third of patients are split 1:2 in the cervical and lumbar regions, respectively.2 The posterior half of the vertebral body is usually infiltrated first, with the anterior body, lamina, and pedicles becoming involved later. 4 The treatment regimen for spinal metastasis is generally palliative and consists of a combination of medical therapy (steroids, pain medication, and chemotherapy), radiation therapy, and surgery.The primary goals of treatment are to relieve pain and preserve or restore function when managing patients affected by spinal metastasis. Patients with metastatic spine disease typically present with progressive and unrelenting pain that is not alleviated with rest and is often worse at night. Pain is generally described in at least 1 of 3 ways: 1) constant and localized, 2) radicular, or 3) axial, coinciding with functional disability. Localized pain is generally thought to be a result of periosteal stretch occurring with tumor expansion and is usually treated by using radiation because this therapy is effective in decreasing the tumor size. Radicular pain, most likely due to the tumor pressing against the nerve root, is also addressed by using radiation therapy but can be treated by using nerve root blocks as well. Axial pain, most frequently associated with mechanical instability of the spine or pathologic vertebral body fracture, is worsened with physical act...

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The effect of pre-vertebroplasty tumor ablation using laser-induced thermotherapy on biomechanical stability and cement fill in the metastatic spine

Cited by 27 publications

References 33 publications

Vertebral Augmentation for Neoplastic Lesions with Posterior Wall Erosion and Epidural Mass

Vertebral Augmentation for Neoplastic Lesions with Posterior Wall Erosion and Epidural Mass

Novel methodology for assessing biomaterial–biofluid interaction in cancellous bone

Metastatic Spinal Lesions: State-of-the-Art Treatment Options and Future Trends

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