Clinical Study
Microwave Thermal Ablation of Spinal Metastatic Bone Tumors

https://doi.org/10.1016/j.jvir.2014.06.007Get rights and content

Abstract

Purpose

To assess feasibility, safety, and efficacy of microwave ablation of spinal metastatic bone tumors.

Materials and Methods

Retrospective study of 17 patients with 20 spinal metastatic tumors treated with microwave ablation under computed tomographic guidance between March 2011 and August 2013 was performed. Ablations were performed under local anesthesia and nitrous oxide ventilation. Lesions were lumbar (n = 10), sacral (n = 7), and thoracic (n = 3) in location. Primary neoplastic sites were lung (n = 9), prostate (n = 4), kidney (n = 6), and uterus (n = 1). Adjunct cementoplasty was performed in nine cases, and a temperature-monitoring device was used in four cases. Procedure effectiveness was evaluated by visual analog scale (VAS) during a 6-month follow-up. Patient medical records were reviewed, and demographic and clinical data, tumor characteristics, and information on pain were assessed.

Results

Mean ablation time was 4.4 minutes ± 2.7 (range, 1–8 min), with an average of 3.8 cycles per ablation at 60 W (range, 30–70 W). The preprocedure mean VAS score was 7.4 ± 1.2 (range, 6–9). Pain relief was achieved in all but one patient. Follow-up VAS scores were as follows: day 0, 1.3 ± 1.8 (P < .001); day 7, 1.6 ± 1.7 (P < .001); month 1, 1.9 ± 1.6 (P < .001); month 3, 2.2 ± 1.5 (P < .001); and month 6, 2.3 ± 1.4 (P < .01). No complications were noted.

Conclusions

Microwave ablation appears to be feasible, safe, and an effective treatment of painful refractory spinal metastases and may be considered as a potential alternative percutaneous technique in the management of spinal metastases.

Section snippets

Materials and Methods

Local institutional review board approval was obtained, and written informed consent was waived. The medical records of patients were reviewed, and the following data were collected and evaluated: demographic and clinical data, tumor characteristics, and information about pain.

Procedure

Technical success was achieved in 100% of cases. The mean ablation time was 4.4 minutes ± 2.7 (range, 1–8 min), with an average of 3.8 cycles per ablation and a mean ablation power of 60 W (range, 30–70 W). Two patients underwent a second ablation session as a result of tumor recurrence. No complications were noted during or after the procedures. Analyses of the postprocedural CT scans did not reveal any immediate procedure-related complications.

Pain

The preprocedure mean VAS score was 7.4 ± 1.2

Discussion

The present study showed that microwave ablation of spinal metastatic lesions appears to be a feasible and effective procedure for pain relief in patients with refractory painful spinal tumors. Indeed, immediate pain reduction was obtained following all but one procedure, and pain relief lasted 6 months. These results were obtained with a minimally invasive procedure under local anesthesia, with no complications. Pain alleviation was obtained immediately after the procedure (compared with the

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    From the SIR 2013 Annual Meeting.

    None of the authors have identified a conflict of interest.

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