title: Interventional tumor removal: a new technique for malignant spinal tumor and malignant vertebral compression fractures without epidural involvement.
abstract: BACKGROUND
  Percutaneous vertebroplasty (PVP) is associated with incomplete pain relief and vertebral instability due to cement leakages.
  
  
  OBJECTIVE
  To evaluate the feasibility of a new method of PVP, radiofrequency ablation (RFA) and interventional tumor removal (ITR) for malignant spinal tumor and malignant vertebral compression fractures without epidural involvement.
  
  
  METHODS
  Twelve patients were treated with PVP, RFA, and ITR. A 14 G needle and a guidewire were inserted into the vertebral body, followed by sequential dilatation of the tract with the working cannula until the last working cannula reached the anterior portions of the pedicle. Thereafter, tumors were ablated with a radiofrequency probe, and ITR was performed with a marrow nucleus rongeurs. Then, cement was injected into the extirpated vertebral body. The data were collected and follow-up was performed after 1, 3, and 6 months, and thereafter every 6 months postoperatively.
  
  
  RESULTS
  PVP, RFA, and ITR were technically successful in all patients. The average preoperative pain visual analog scale (VAS) score was 7.0 ± 1.0, which decreased to 2.1 ± 1.2 at 1 month, to 1.6 ± 1.4 at 6 months, to 1.8 ± 1.7 at 1 year, and was maintained at 1.3 ± 1.1 at >1-year follow-up. A total of 92% patients (11/12) obtained excellent and good pain relief with improvement of quality of life. Seven patients continued with follow-up healthcare, and five patients died of the underlying disease.
  
  
  CONCLUSIONS
  PVP, RFA, and ITR may be a feasible approach for malignant spinal tumor and malignant vertebral compression fractures without epidural involvement.
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Song
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Yi-Feng
authors.initials: YF
authors.lastname: Gu
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Yong-Dong
authors.initials: YD
authors.lastname: Li
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China wucgsh@163.com.
authors.forename: Chun-Gen
authors.initials: CG
authors.lastname: Wu
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Zhen-Kui
authors.initials: ZK
authors.lastname: Sun
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Cheng-Jian
authors.initials: CJ
authors.lastname: He
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011788:Quality of Life; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
keywords: Percutaneous vertebroplasty; extirpation; malignant spinal tumor; metastasis; pain; radiofrequency ablation