A preliminary study of the safety and efficacy of radiofrequency ablation with percutaneous kyphoplasty for thoracolumbar vertebral metastatic tumor treatment.
BACKGROUND
Thoracolumbar vertebral metastasis (TVM) affects a large number of cancer patients. However, safe and effective palliative care remains controversial. The aim of the present study was to investigate the safety and efficacy of minimally invasive image-guided radiofrequency ablation (RFA) with percutaneous kyphoplasty (PKP) for TVM treatment.


METHODS
A retrospective study of 26 patients (mean age: 59.31 ± 11.62 years) was conducted, including 38 vertebral metastases at T11, T12, L1, L2, L3, L4, L5, and S1 with abundant blood vessels. Patients underwent RFA with PKP (4-6 min, 95 ± 5°C, 150 W, effective electrode area of 1.5-2.0 cm) under general anesthesia from February 2005 to January 2009. Electrodes were inserted into the lesions and pre- and post-operative visual analog scale (VAS) scores and X-rays were collected on day 3, week 1, and months 1, 3, and 6. Tumor recurrence and pain level were also evaluated. Safety assessment was conducted based on complications and adverse events. The mean follow-up time was 8.4 ± 2.1 months.


RESULTS
A mean of 2.69 ± 0.93 ablation was performed per patient. The ablation procedure required a mean of 15.08 ± 4.64 min, while the injection of bone cement required a mean of 6.73 ± 0.83 min, for a mean total operating time of 47.77 ± 7.13 min. Postoperative VAS scores were significantly lower on day 3, week 1, and months 1, 3, and 6 (P<0.01), without any complications or tumor recurrence.


CONCLUSIONS
Image-guided RFA with PKP was safe and effective for TVM treatment when used with careful consideration of bone cement volume/viscosity, injection location, and temperature.
Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Longpo
L
Zheng
Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Zhengqi
Z
Chen
Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Mengxiong
M
Sun
Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Hui
H
Zeng
Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Dongqing
D
Zuo
Musculoskeletal Oncology Center, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Yingqi
Y
Hua
Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai, China (mainland).
Zhengdong
Z
Cai
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects*; D003710:Demography; D004566:Electrodes; D005260:Female; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010147:Pain Measurement; D011182:Postoperative Care; D011300:Preoperative Care; D011859:Radiography; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome