Computed tomography-guided microwave ablation combined with percutaneous vertebroplasty for treatment of painful high thoracic vertebral metastases

Int J Hyperthermia. 2021;38(1):1069-1076. doi: 10.1080/02656736.2021.1951364.

Abstract

Purpose: To retrospectively evaluate the efficacy and safety of computed tomography (CT)-guided microwave ablation (MWA) combined with percutaneous vertebroplasty (PVP) as a treatment for painful high thoracic vertebral metastases (T1-T4).

Materials and methods: In this retrospective study, 23 adult patients (33 high thoracic vertebral metastases) with moderate to severe pain were treated with CT-guided MWA and PVP. The procedural effectiveness was evaluated using a Visual Analog Scale (VAS), daily morphine consumption, and the Oswestry Disability Index (ODI) before and immediately after the procedure and during follow-up.

Results: Technical success was achieved in all patients. The mean pre-procedure VAS score and morphine doses were 6.7 ± 1.7 (5-10) and 105.2 ± 32.7 (30-150) mg, respectively. The mean VAS scores and daily morphine doses at 24 h and 1, 4, 12, and 24 weeks post-operatively were 3.2 ± 1.4 and 41.3 ± 9.6 mg; 1.8 ± 1.0 and 31.5 ± 12.2 mg; 1.4 ± 1.3 and 19.6 ± 12.4 mg; 1.1 ± 0.8 and 14.5 ± 9.6 mg; and 1.0 ± 0.7 and 13.9 ± 9.3 mg, respectively (all p < 0.001). ODI scores significantly decreased (p < 0.05). Minor cement leakage occurred in 10 patients (30.30%) with no symptoms. Follow-up imaging showed no local tumor progression.

Conclusions: Preliminary results suggest MWA combined with PVP is an effective and safe treatment for painful high thoracic vertebral metastases (T1-T4) and can significantly relieve pain and improve the quality of life of patients. However, its efficacy should be confirmed by mid- and long-term studies.

Keywords: Computed tomography; microwave ablation; percutaneous vertebroplasty; thoracic vertebrae; visual analog scale.

MeSH terms

  • Adult
  • Bone Cements
  • Humans
  • Microwaves / therapeutic use
  • Pain / etiology
  • Quality of Life
  • Retrospective Studies
  • Spinal Fractures*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vertebroplasty*

Substances

  • Bone Cements