Image-guided radiofrequency ablation (RFA) of spinal tumors.
OBJECTIVE
To evaluate retrospectively the efficacy and safety of radiofrequency ablation (RFA) in patients with spinal tumors.


METHODS
Forty-one patients (25 men, 16 women; age range, 46-82 years) with nonresectable primary or secondary tumor involvement of the spine unresponsive to chemo- and radiotherapy received RFA treatment. Two radiofrequency ablation systems, one with a cool-tip electrode and one with an expandable electrode catheter, were used. Both systems work impedance controlled with a power output of 150- 200 W. Each coagulation cycle lasted 12-15 min depending on tumor impedance. Several single RFA cycles of 15 min each were used for overlapping RFAs in tumors with diameters of more than 3 cm. Temperature was kept between 50 degrees C and 120 degrees C and was chosen according to spinal cord distance and patient heat tolerance during the ablation. Multi-slice computed tomography (CT) combined with C-arm fluoroscopy guided the intervention. Efficacy outcomes were assessed after about 6 weeks, 6 months, and more than 6 months using standardized questionnaires and indices regarding tumor pain, pain disability, functional activities, quality of life, neurological status, and tumor progression.


RESULTS
RFA significantly reduced tumor-induced pain within 6 weeks, improved daily activities, and maintained quality of life. Mean time to tumor progression was 730+/-54 days (Kaplan-Meier estimate). No RFA-associated complications were reported.


CONCLUSIONS
RFA of primary and secondary spinal tumors, which were unresponsive to chemo- and radiotherapy and prone to progression, is a safe, resource-saving, and highly effective percutaneous technique in patients with nonresectable spinal tumors.
Gevargez
Athour
A
Groenemeyer Institute of MicroTherapy, Bochum, Germany. gevargez@microtherapy.de
Groenemeyer
Dietrich H W
DH
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome