Radiofrequency ablation during open surgery: a palliative treatment for spinal metastases

English Keywords:Spinal metastases  Palliative treatment  Posterior surgery  Radiofrequency ablation

English Abstract:

  【Abstract】 Objectives: To investigate the outcome of radiofrequency ablation in surgery for spinal metastases. Methods: The study was a retrospective review of 30 cases of spinal neoplastic metastases treated in our center between April 2012 and January 2015, including 17 males and 13 females, with an average age of 56±14 years(range, 17-80 years). The affected vertebrae were located in thoracic spine(17 patients), lumbar spine(9 patients), both thoracic and lumbar spine(4 patients). The sites of primary cancer were: lung(6 cases), kidney(5 cases), each 2 cases at liver, mammary gland, soft tissue, prostate and thyroid, and 9 cases with various histological type. All patients underwent posterior open surgery assisted with radiofrequency ablation. Results: The mean blood loss was 1083±1193ml(range, 250-5400ml), complications included 3 cases of CSF leak, 2 cases of asymptomatic bone cement leakage, 1 case of epidural hematoma and 1 case of wound infection. All were healed after surgical or non-surgical treatment. The mean visual analog score(VAS) before surgery was 4.3, which dropped to 1.3 at one month after surgery(P＜0.05), 26 out of 30 patients(86.7%) received pain relief, and an improved or a stable neural function was presented in all 30 patients. The mean follow-up time was 10±8 months, during which all patients except three were free of local tumor recurrence. Conclusions: With less surgical trauma, RFA assisted open surgery is able to serve as a palliative approach to achieve low complication rate, relieved pain, improved neural functions and satisfying local tumor control.