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Cryoablation/Vertebroplasty versus Radiofrequency/Vertebroplasty in neoplastic vertebral localisation 2012

Interventional Spine

Francesco, Massari, M.D./P.h.D.
Salvatore, A, Masala, Prof., Non ASSR Member
Giovanni, Simonetti, Prof., Non ASSR Member

Paper/Non-Mentor

Purpose

The aim of our study was to emphasize the state of the art in vertebral neoplastic percutaneous palliative treatment by comparing the Visuale Analogue Scale (VAS) scores in cryoablation plus vertebroplasty versus radiofrequency plus vertebroplasty, and their feasibility, reliability and efficacy in short term series.

Methods & Materials

Combined procedure of Radiofrequency (RF) thermal ablation plus vertebroplasty or Cryoablation plus vertebroplasty were performed in osteolytic neoplastic localizations in 45 consecutive patients suffering for pain refractory to conservative therapies. We evaluated pain with a "Visual Analogue Scale" (VAS), performed in the preoperative period and at 4 hours, 24 hours, 1 week, 1 month, 3 months and 6 months from the procedure.

Results

There were no statistical significant differences in the VAS score between patients treated with Cryoablation and vertebroplasty and those treated with RF ablation and vertebroplasty at 1 week (p=0.34), 1 month (p=1), 3 months (p=0.68) and 6 months (p=0.65). Patients treated with Cryoablation and vertebroplasty have less pain at 4 hours (p<0.001) and at 24 hours (p<0.001) than patients treated with RF ablation and vertebroplasty.

Conclusion

Both RF-ablation and cryoablation are optimal techniques in the treatment of painful vertebral neoplastic lesions. Cryoablation achieves reduced treatment related pain in the early follow-up time and a better volume control by real-time depiction of ablation margins.

References/Financial Disclosures

Palliation of painful metastatic disease involving bone with imaging-guided treatment: comparison of patients' immediate response to radiofrequency ablation and cryoablation. Thacker PG, Callstrom MR, Curry TB, Mandrekar JN, Atwell TD, Goetz MP, Rubin J. AJR Am J Roentgenol. 2011 Aug;197(2):510-5. Fire and ice: percutaneous ablative therapies and cement injection in management of metastatic disease of the spine. Munk PL, Murphy KJ, Gangi A, Liu DM. Semin Musculoskelet Radiol. 2011 Apr;15(2):125-34.

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