Radiofrequency Ablation of Spine

You, Nam Kyu; Lee, Hye Yeong; Shin, Dong Ah; Choi, Gwi Hyun; Yi, Seong; Kh, Kim; Yoon, Doe Hyun; Park, Jon

doi:10.1097/brs.0b013e31829c2e12

Cited by 5 publications

(2 citation statements)

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“…The earliest RFAs were performed with monopolar electrodes which could only create the maximal coagulation diameter of 1.6 cm and were not adequate for most tumors. However, as modification of RFA electrode design has advanced with development of multiprobe arrays, bipolar arrays, internally cooled electrodes and cluster or pulsed radiofrequency, a significantly increased coagulation area can now be achieved [25] . After studying radiofrequency ablation in pig spine with an internally cooled electrode containing an adjustable tip, You et al [25] found that the coagulation area was 4.19 ± 2.95 cm 3 (1.26–3.05 cm in diameter) in an in vitro experiment but 6.80 ± 2.72 cm 3 (1.28–2.51 cm in diameter) in an in vivo experiment, with the average temperature in the epidural space of the pig of 34.9 °C at the end of 20-min ablation but 38.2 °C at the end of 30-min ablation.…”

Section: Discussionmentioning

confidence: 99%

“…However, as modification of RFA electrode design has advanced with development of multiprobe arrays, bipolar arrays, internally cooled electrodes and cluster or pulsed radiofrequency, a significantly increased coagulation area can now be achieved [25] . After studying radiofrequency ablation in pig spine with an internally cooled electrode containing an adjustable tip, You et al [25] found that the coagulation area was 4.19 ± 2.95 cm 3 (1.26–3.05 cm in diameter) in an in vitro experiment but 6.80 ± 2.72 cm 3 (1.28–2.51 cm in diameter) in an in vivo experiment, with the average temperature in the epidural space of the pig of 34.9 °C at the end of 20-min ablation but 38.2 °C at the end of 30-min ablation. After evaluation of a bipolar-cooled RFA device for bone metastases in porcine vertebrae, Pezeshki et al [26] found that the coagulation necrosis volume created by this bipolar device was 2.24 ± 0.90 cm 3 with the mean temperature on the surface of the vertebral body of 36.1 °C (range 32–40 °C) at the end of 15-min ablation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Thermal effect of percutaneous radiofrequency ablation with a clustered electrode for vertebral tumors: In vitro and vivo experiments and clinical application

Zhao

Peng

Chen

et al. 2018

Journal of Bone Oncology

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PurposeTo investigate effects and heat distribution of radiofrequency ablation (RFA) on vertebral tumors in vitro and in vivo swine experiments and its clinical application.Materials and methodsRFA was performed on the swine spine in vitro and in vivo for 20 min at 90 °C at the electrode tip, and the temperature at the electrode tip and surrounding tissues were recorded. Clinical application of ablation combined with vertebroplasty was subsequently performed in 4 patients with spinal tumors.ResultsIn the in vitro study, the mean temperature at the front and ventral wall of the spinal canal was 50.8 °C and 43.6 °C, respectively, at 20 mm significantly greater than 37.7 °C and 33.7 ± 1.7 °C, respectively, at 10 mm ablation depth. The coagulative necrosis area was significantly (P < 0.0001) greater at 20 mm depth than at 10 mm depth (mean 17.0 × 20.7 mm2 vs. 14.2 × 16.6 mm2). In the in vivo experiment, the local temperature increased significantly (P < 0.05) from around 36 °C before ablation to over 41 °C at 20 min after ablation, with the temperature at the electrode tip (90.4 °C) and within the vertebral body (67.0 °C) significantly (P < 0.05) greater than at the posterior (41.9 °C) and lateral wall (41.8 °C). From 2 to 5 weeks, bone remodeling began. Clinically, all four patients had successful RFA and vertebroplasty, with no neurological deficits. The pain scores were significanlty (P < 0.05) improved before (4.5–10, mean 8.0) compared with at four weeks (0–1.8, mean 1.8).ConclusionThe clustered electrode can be efficiently and safely applied in the treatment of spinal tumors without damaging the spinal cord and adjacent nerves by heat distribution.

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Section: Discussionmentioning

confidence: 99%