title: Comparison of the effect of two different bone-targeted radiofrequency ablation (RFA) systems alone and in combination with percutaneous vertebroplasty (PVP) on the biomechanical stability of the metastatic spine.
abstract: Radiofrequency ablation (RFA) and percutaneous vertebroplasty (PVP) are used independently and in combination to treat metastatically involved vertebrae with the aim of relieving pain, reducing tumour burden and providing bony mechanical stabilization.
  
  
  
  The aim of this work was to characterize the effect of two bone-targeted RFA devices, alone and in combination with PVP, to improve strength and mechanical stability in vertebrae with osteolytic metastatic disease.
  
  
  
  Simulated spinal metastases (n = 12) were treated with one of two bone-targeted RFA devices (bipolar cooled or bone coil RF electrodes), followed by PVP. Under axial compressive loading, spinal canal narrowing was measured in the intact specimen, after tumour simulation, post-RFA and post-PVP.
  
  
  
  RFA alone resulted in successful tumour shrinkage and cavitation, but further increased canal narrowing under loading. RFA combined with PVP significantly reduced posterior wall stability in samples where sufficient tumour shrinkage and cavitation were coupled with a pattern of cement deposition which extended to posterior vertebral body.
  
  
  
  RFA combined with cement deposition in the posterior vertebral body demonstrates significantly more stable vertebrae under axial loading.
authors.affiliation: University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada.|Sunnybrook Research Institute, 2075 Bayview Ave., Room S620, Toronto, ON, M4N 3M5, Canada.
authors.forename: Padina S
authors.initials: PS
authors.lastname: Pezeshki
authors.affiliation: Techna Institute, University Health Network, 124-100 College Street, Toronto, ON, M5G 1P5, Canada.
authors.forename: Sean
authors.initials: S
authors.lastname: Davidson
authors.affiliation: University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada.|Techna Institute, University Health Network, 124-100 College Street, Toronto, ON, M5G 1P5, Canada.
authors.forename: Kieran
authors.initials: K
authors.lastname: Murphy
authors.affiliation: Sunnybrook Research Institute, 2075 Bayview Ave., Room S620, Toronto, ON, M4N 3M5, Canada.
authors.forename: Claire
authors.initials: C
authors.lastname: McCann
authors.affiliation: Sunnybrook Research Institute, 2075 Bayview Ave., Room S620, Toronto, ON, M4N 3M5, Canada.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Slodkowska
authors.affiliation: University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada.|Techna Institute, University Health Network, 124-100 College Street, Toronto, ON, M5G 1P5, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Sherar
authors.affiliation: University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada.|Sunnybrook Research Institute, 2075 Bayview Ave., Room S620, Toronto, ON, M4N 3M5, Canada.
authors.forename: Albert Jm
authors.initials: AJ
authors.lastname: Yee
authors.affiliation: University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada. cari.whyne@sunnybrook.ca.|Sunnybrook Research Institute, 2075 Bayview Ave., Room S620, Toronto, ON, M4N 3M5, Canada. cari.whyne@sunnybrook.ca.
authors.forename: Cari M
authors.initials: CM
authors.lastname: Whyne
mesh_terms: D017115:Catheter Ablation / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D013125:Spinal Neoplasms / Q000601:surgery*; D013131:Spine / Q000601:surgery*; D054854:Vertebroplasty / Q000379:methods / Q000706:statistics & numerical data
keywords: Bone-targeted radiofrequency ablation; Mechanical stabilization; Percutaneous vertebroplasty; Spinal metastases