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Combined use of percutaneous cryoablation and vertebroplasty with 3D rotational angiograph in treatment of single vertebral metastasis: comparison with vertebroplasty

  • Interventional Neuroradiology
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Abstract

Introduction

This study aims to assess the effectiveness of combined procedure of cryoablation and vertebroplasty (CVT) for reduction of pain and improvement of the quality of life in patients with single painful metastatic vertebral fractures.

Methods

We retrospectively analyzed data from 23 patients with single vertebral metastasis treated with combined procedure of CVT, compared with those obtained in 23 patients treated by vertebroplasty. Pain intensity was evaluated by a visual analog scale (VAS) score administered before and 1 day, 1 week, and 1, 3, and 6 months after procedure. Quality of life was evaluated by an Oswestry Disability Index (ODI) score administered before and at 3 and 6 months after procedure.

Results

Procedural success was achieved in all patients without any complications. The VAS and ODI scores showed a reduction in both groups during follow-up (VAS score, p < 0.05 and p < 0.001, respectively; ODI score, p < 0.0001). No difference of the VAS and ODI scores were observed before treatment (p = 0.33 and 0.78, respectively). VAS score showed a difference at 1 week and 1, 3, and 6 months after treatment (p < 0.001). ODI score showed a difference at 3 and 6 months after treatment (p < 0.001).

Conclusion

Our findings suggested that combined procedure of CVT is safe and effective for pain relief in single metastatic vertebral fractures, especially when other standard palliative treatments have failed, and improves disability. Careful needle positioning and accurate fluoroscopic and CT guidance are mandatory for a complication-free treatment.

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References

  1. Bartels RH, van der Linden YM, van der Graaf WT (2008) Spinal extradural metastasis: review of current treatment options. CA Cancer J Clin 58(4):245–259

    Article  PubMed  Google Scholar 

  2. Chow E, Harris K, Fan G, Tsao M, Sze WM (2007) Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol 25(11):1423–1436

    Article  PubMed  Google Scholar 

  3. Georgy BA (2008) Metastatic spinal lesions: state-of-the-art treatment options and future trends. AJNR Am J Neuroradiol 29(9):1605–1611

    Article  PubMed  CAS  Google Scholar 

  4. Gangi A, Kastler B, Klinkert A, Dietemann JL (1994) Injection of alcohol into bone metastases under CT guidance. J Comput Assist Tomogr 18(6):932–935

    Article  PubMed  CAS  Google Scholar 

  5. Cotten A, Demondion X, Boutry N, Cortet B, Chastanet P, Duquesnoy B et al (1999) Therapeutic percutaneous injections in the treatment of malignant acetabular osteolyses. Radiographics 19(3):647–653

    PubMed  CAS  Google Scholar 

  6. Gangi A, Gasser B, De Unamuno S, Fogarrassy E, Fuchs C, Siffert P et al (1997) New trends in interstitial laser photocoagulation of bones. Semin Musculoskelet Radiol 1(2):331–338

    Article  PubMed  Google Scholar 

  7. Gröenemeyer DH, Schirp S, Gevargez A (2002) Image-guided percutaneous thermal ablation of bone tumors. Acad Radiol 9(4):467–477

    Article  PubMed  Google Scholar 

  8. Georgy BA (2009) Percutaneous image-guided augmentation for spinal metastatic tumors. Tech Vasc Interv Radiol 12(1):71–77

    Article  PubMed  Google Scholar 

  9. Pilitsis JG, Rengachary SS (2001) The role of vertebroplasty in metastatic spinal disease. Neurosurg Focus 11(6):e9

    Article  PubMed  CAS  Google Scholar 

  10. Bròdano GB, Cappuccio M, Gasbarrini A, Bandiera S, De Salvo F, Cosco F et al (2007) Vertebroplasty in the treatment of vertebral metastases: clinical cases and review of the literature. Eur Rev Med Pharmacol Sci 11(2):91–100

    PubMed  Google Scholar 

  11. Alvarez L, Pérez-Higueras A, Quiñones D, Calvo E, Rossi RE (2003) Vertebroplasty in the treatment of vertebral tumours: postprocedural outcome and quality of life. Eur Spine J 12(4):356–360

    Article  PubMed  CAS  Google Scholar 

  12. Callstrom MR, Atwell TD, Charboneau JW, Farrell MA, Goetz MP, Rubin J et al (2006) Painful metastases involving bone: percutaneous image-guided cryoablation-prospective trial interim analysis. Radiology 241(2):572–580

    Article  PubMed  Google Scholar 

  13. Posteraro A, Dupuy D, Mayo-Smith WW (2004) Radiofrequency ablation of bony metastatic disease. Clin Radiol 59(9):803–811

    Article  PubMed  CAS  Google Scholar 

  14. Callstrom MR, Charboneau JW, Goetz MP, Rubin J, Atwell TD, Farrell MA, Welch TJ, Maus TP (2006) Image-guided ablation of painful metastatic bone tumors: a new and effective approach to a difficult problem. Skeletal Radiol 35(1):1–15

    Article  PubMed  Google Scholar 

  15. Masala S, Mastrangeli R, Petrella MC, Massari F, Ursone A, Simonetti G (2009) Percutaneous vertebroplasty in 1,253 levels: results and long-term effectiveness in a single centre. Eur Radiol 19(1):165–171

    Article  PubMed  Google Scholar 

  16. Bohm P, Huber J (2002) The surgical treatment of bony metastases of spine and limbs. J Bone Joint Surg Br 84(4):521–529

    Article  PubMed  CAS  Google Scholar 

  17. Harel R, Angelov L (2010) Spine metastases: current treatments and future directions. Eur J Cancer 46(15):2696–2707

    Article  PubMed  Google Scholar 

  18. Sciubba DM, Nguyen T, Gokaslan ZL (2009) Solitary vertebral metastasis. Orthop Clin N Am 40(1):145–154

    Article  Google Scholar 

  19. Masala S, Roselli M, Manenti G, Mammucari M, Bartolucci DA, Simonetti G (2008) Percutaneous cryoablation and vertebroplasty: a case report. Cardiovasc Interv Radiol 31(3):669–672

    Article  Google Scholar 

  20. Reidy D, Ahn H, Mousavi P, Finkelstein J, Whyne CM (2003) A biomechanical analysis of intravertebral pressures during vertebroplasty of cadaveric spines with and without simulated metastases. Spine (Phila Pa 1976) 28(14):1534–1539

    Google Scholar 

  21. Masala S, Roselli M, Massari F, Fiori R, Ursone A, Fossile E et al (2004) Radiofrequency heat ablation and vertebroplasty in the treatment of neoplastic vertebral body fractures. Anticancer Res 24(5B):3129–3133

    PubMed  Google Scholar 

  22. Georgy BA, Wong W (2007) Plasma-mediated radiofrequency ablation assisted percutaneous cement injection for treating advanced malignant vertebral compression fractures. AJNR Am J Neuroradiol 28(4):700–705

    PubMed  CAS  Google Scholar 

  23. Schaefer O, Lohrmann C, Herling M, Uhrmeiser P, Langer M (2002) Combined radiofrequency thermal ablation and percutaneous cementoplasty treatment of a pathologic fracture. J Vasc Interv Radiol 13(10):1047–1050

    Article  PubMed  Google Scholar 

  24. Toyota N, Naito A, Kakizawa H, Hieda M, Hirai N, Tachikake T et al (2005) Radiofrequency ablation combined with cementoplasty for painful bone metastases: initial experience. Cardiovasc Interv Radiol 28(5):578–583

    Article  Google Scholar 

  25. Buy X, Basile A, Bierry G, Cupelli J, Gangi A (2006) Saline infused bipolar radiofrequency ablation of high-risk spinal and paraspinal neoplasms. AJR Am J Roentgenol 186:S322–326

    Article  PubMed  Google Scholar 

  26. Gage AA, Baust JM, Baust JG (2009) Experimental cryosurgery investigations in vivo. Cryobiology 59(3):229–243

    Article  PubMed  CAS  Google Scholar 

  27. Masala S, Manenti G, Roselli M, Mammucari M, Bartolucci DA, Formica V (2007) Percutaneous combined therapy for painful sternal metastases: a radiofrequency thermal ablation (RFTA) and cementoplasty protocol. Anticancer Res 27(6C):4259–4262

    PubMed  Google Scholar 

  28. Pedicelli A, Verdolotti T, Pompucci A, Desiderio F, D’Argento F, Colosimo C et al (2011) Interventional spinal procedures guided and controlled by a 3D rotational angiographic unit. Skeletal Radiol 40(12):1595–1601

    Article  PubMed  Google Scholar 

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Masala, S., Chiocchi, M., Taglieri, A. et al. Combined use of percutaneous cryoablation and vertebroplasty with 3D rotational angiograph in treatment of single vertebral metastasis: comparison with vertebroplasty. Neuroradiology 55, 193–200 (2013). https://doi.org/10.1007/s00234-012-1096-7

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  • DOI: https://doi.org/10.1007/s00234-012-1096-7

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