Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases

Cardiovasc Intervent Radiol. 2016 Sep;39(9):1289-97. doi: 10.1007/s00270-016-1400-8. Epub 2016 Jun 24.

Abstract

Background: Radiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM.

Methods: Fifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval.

Results: Twenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported.

Conclusion: RFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

Keywords: Cement augmentation; Radiofrequency ablation; Spinal metastases; Vertebral augmentation; Vertebral body metastases.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Cements / therapeutic use
  • Catheter Ablation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / complications*
  • Pain / surgery
  • Pain Measurement
  • Prospective Studies
  • Quality of Life
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / secondary*
  • Spinal Neoplasms / surgery*
  • Spine / surgery
  • Treatment Outcome
  • Young Adult

Substances

  • Bone Cements