Radiofrequency ablation combined with percutaneous vertebroplasty in the treatment of spinal metastasis

English Keywords:Spinal metastasis  Radiofrequency ablation  Percutaneous vertebroplasty  Bone cement

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical outcomes of radiofrequency ablation combined with percutaneous vertebroplasty in the treatment of spinal metastasis. Methods: Fifty-five patients with spinal metastasis treated from October 2012 to March 2014 were retrospectively analyzed. 28 patients were only treated with percutaneous vertebroplasty(PVP group) and the other 27 patients were treated with radiofrequency ablation combined with percutaneous vertebroplasty(PVP+RFA group). PVP group comprised 20 males and 7 females with a mean age of 47.0±8.5 years. Similarly, 19 males and 9 females were in PVP+RFA group with a mean age of 49.0±7.6 years. The clinical outcomes were assessed by visual analogue scale(VAS) and Karnofsky(KPS). Recorded data also included the percentage of bone cement leakage and tumor recurrence rate. Survival analysis was evaluated by Kaplan-Meier. Results: The period of follow-up ranged from 6 to 18 months with a mean time of 11.68±3.29 months(PVP group) and 12.19±3.33 months(PVP+RFA group), the VAS score improved at 6 months after operation in both groups(from 7.86±0.85 to 3.07±0.90 in group PVP, and from 7.67±0.96 to 2.96±0.94 in group PVP+RFA). Pain was relieved in all the patients, but there was no significant difference between the two groups preoperatively and at 6 months after operation(P＞0.05). The mean KPS in both groups increased after surgery. But no significant difference was found between the two groups(P＞0.05). The percentage of bone cement leakage was 42.86% in PVP group and 11.11% in PVP+RFA group. The tumor recurrence rate of the two groups was 32.14%(PVP group) and 7.41%(PVP+RFA group) respectively. There were significant differences of the percentage of bone cement leakage and the tumor recurrence rate in the two groups(P＜0．05). The median survival time of PVP group was 12 months and 13 months of PVP+RFA group. The survival time was similar in the two groups after operation. No significant difference was found between the two groups(P＞0.05). Conclusions: In treatment for spinal metastasis, radiofrequency ablation combined with percutaneous vertebroplasty not only gets similar effect with simple percutaneous vertebroplasty, but also reduces the percentage of bone cement leakage and controlled tumor progression in the early stage after operation.