Motor Evoked Potential Monitoring during Cryoablation of Musculoskeletal Tumors

Spine Cryoablation: Pain Palliation and Local Tumor Control for Vertebral Metastases

“…34 Investigators have reported scattered cases of spinal metastases treated with percutaneous cryoablation as part of larger series of patients ablated for extraspinal musculoskeletal metastatic disease or as case series. 14,18,20,23,26 In cygeal metastases who underwent imaging-guided cryoablation and suggested that cryoablation may be a safe and relatively effective technique for the management of recurrent sacrococcygeal neoplasms for local control or palliation of pain with short-term follow-up. In 2014, Prologo el al 23 reported 2 patients with pedicle lesions as part of larger series of 50 patients with musculoskeletal metastases managed by cryoablation for pain palliation.…”

“…In 2014, Prologo el al 23 reported 2 patients with pedicle lesions as part of larger series of 50 patients with musculoskeletal metastases managed by cryoablation for pain palliation. Subsequently, in 2014, Kurup et al 26 reported the utility of motorevoked potential monitoring during cryoablation of musculoskeletal tumors in 52 patients. The authors reported cryoablation in 27 spine and 3 sacral tumors, which were monitored by motorevoked potentials.…”

“…However, the effectiveness of cryoablation for pain palliation and local tumor control was not discussed. 26 In a retrospective analysis of data from patients with single vertebral metastasis, Masala et al 19 described the safety and efficacy-through reduced pain (Visual Analog Scale scores) and disability (Oswestry Disability Index)-of cryoablation combined with vertebroplasty for the palliation of painful vertebral metastases, which was at least equivalent to vertebroplasty alone. However, the safety and efficacy of cryoablation as an exclusive treatment approach could not be evaluated because vertebroplasty was performed in all cases.…”

“…26,27 The cutaneous thermal protection technique consisted of a surface application of warm saline solution in all cases. After ablation, the patients were transferred to a recovery unit for 1 hour of postprocedural observation before being discharged to the patient care division.…”

Benign Spine Lesions: Advances in Techniques for Minimally Invasive Percutaneous Treatment

“…22,26,64,65 Investigators have implemented neurophysiologic monitoring and nerve electrostimulation during spine thermal ablation procedures by using estimations of motor-and somatosensoryevoked potential amplitudes. 65,66 Substantial reduction in the amplitude of evoked potential amplitudes affords early detection of impending neurologic injury, which should prompt active thermoprotection or modification in the ablation procedure. Skin injury is another potential complication of percutaneous thermal ablation.…”