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Radiofrequency Ablation of Spinal Metastases 2013

Category Interventional Jonathan Friedman
Anthony Whittemore
David P. Chason
Purpose Spinal metastases are the most common site of osseous metastatic disease with a high incidence among patients with multiple different primary cancers.  Treatment is primarily aimed at palliation with the primary goals of durable pain relief and amelioration of pain related disability.  Treatment options for spinal metastases include external beam radiation, chemotherapy, surgery and minimally invasive percutaneous techniques such as radiofrequency ablation.   This educational exhibit will serve as a tutorial for fellows and residents to learn how to perform percutaneous RFA of spinal metastatic lesions. The exhibit will discuss basic concepts of RFA as well as highlight newer techniques focused on a single needle approach that can be done in conjunction with biopsy and/or vertebroplasty.  Awareness of percutaneous RFA will allow training neuroradiologists to expand their services to include palliation of painful metastatic lesions. Materials & Methods Learning points: 1. Identify criteria for patient selection, including indications and contraindications for RFA of spinal metastases, based on both clinical data and imaging studies. 2. Illustrate needle placements and approaches used to perform percutaneous RFA of spinal metastases. 3. Discuss the underlying thermal properties of RFA and how to utilize and monitor RFA probes to treat spinal metastases and minimize the risks of thermal injuries.  4. Describe newer devices, including navigational osteotomes and steerable RFA devices, that allow for a single needle approach and integration of concurrent biopsy and/or vertebral body augmentation.   Results Conclusion References