Plasma-Mediated Radiofrequency Ablation Assisted Percutaneous Cement Injection for Treating Advanced Malignant Vertebral Compression Fractures
B.A. Georgya,b and
W. Wongb
a Valley Radiology Consultants, Escondido, Calif
b Department of Radiology, University of California at San Diego, San Diego, Calif
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Fig 1. A, Axial CT scans show a large degree of cortical disruption in a 70-year-old man with metastatic colon cancer.
B and C, The SpineWand device was inserted into the cannula to perform the tissue ablation; the clinician is capable of ablating tissue in a superior or inferior lateral direction.
D, In this patient, 2 10-mm Kyphon balloons were inserted to obtain hemostasis while preparing the bone cement. A myelogram was performed to clearly delineate the posterior cortical margin.
E, The axial CT scans collected immediately after the procedure showed that cement was cleanly deposited in the ablated tumor void with no posterior extraosseous extension of cement.
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Fig 2. A, An axial T1-weighted image through the T11 level showing prominent epidural involvement in a 34-year-old woman with multiple myeloma.
B, The axial CT image showed associated cortical disruption.
C, The axial CT images obtained after the procedure, showing adequate cement filling with no epidural extension. Note the tight thecal sac as evident by using myelographic contrast agent.
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Fig 3. A, The preprocedure axial CT examination showing almost complete absence of the posterior cortex at the L1 level in a 76-year-old man with metastatic hepatoma to the spine.
B, The postprocedural CT axial images showed well-bounded deposition of cement in the anterior part of the vertebral body with no extension into the compromised posterior aspect.
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