Comparison of the postoperative pain change and spinal stenosis rate between percutaneous vertebroplasty combined with radiofrequency ablation and with 125I particle implantation in the treatment of metastatic spinal cord compression: A retrospective study

He, Yu; Han, Shengnan; Wu, Chun; Ge, Fei; Wang, Jianbo

doi:10.1016/j.jimed.2021.10.002

Cited by 1 publication

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“…Nevertheless, lack of RCT studies comparing PVP and RFA antineoplastic effects and tumoral recurrency rates impedes to formulate adequate indications regarding the use of PVP/PKP alone in VBM treatment. Moreover, without any preceding tumor mass ablation procedures, the presence of heterogenous pathological tissue in the context of the vertebral body could alter the distribution of cement, resulting in suboptimal effects on pain relief and spine stabilization [ 9 ]. Bone cement leakage is a common complication in PVP/PKP, reported in 4.8–39% of the cases, although in most case asymptomatic except for less common epidural or intracanalar extravasation, which could present with spinal cord or neural compression symptoms, eventually requiring surgical treatment [ 1 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation in Vertebral Body Metastasis with and without Percutaneous Cement Augmentation: A Systematic Review Addressing the Need for SPINE Stability Evaluation

et al. 2023

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Vertebral body metastases (VBM) are one of the most frequent sites of bone metastasis, and their adequate therapeutic management still represents an insidious challenge for both oncologists and surgeons. A possible alternative treatment for VBM is radiofrequency ablation (RFA), a percutaneous technique in which an alternating current is delivered to the tumor lesion producing local heating and consequent necrosis. However, RFA alone could alter the biomechanics and microanatomy of the vertebral body, thus increasing the risk of post-procedure vertebral fractures and spine instability, and indeed the aim of the present study is to investigate the effects of RFA on spine stability. A systematic review according to PRISMA-P guidelines was performed, and 17 papers were selected for the systematic review. The results show how RFA is an effective, safe, and feasible alternative to conventional radiotherapy for the treatment of VBM without indication for surgery, but spine stability is a major issue in this context. Although exerting undeniable benefits on pain control and local tumor recurrence, RFA alone increases the risk of spine instability and consequent vertebral body fractures and collapses. Concomitant safe and feasible therapeutic strategies such as percutaneous vertebroplasty and kyphoplasty have shown synergic positive effects on back pain and improvement in spine stability.

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Section: Discussionmentioning

confidence: 99%