Combined Cementoplasty and Radiofrequency Ablation in the Treatment of Painful Neoplastic Lesions of Bone
Received 8 July 2008; received in revised form 4 March 2009; accepted 30 March 2009. published online 28 May 2009.
Purpose
To assess the safety and effectiveness of combined radiofrequency (RF) ablation and cementoplasty in the treatment of painful neoplastic lesions of bone.
Materials and Methods
The authors performed a retrospective analysis of 25 combined treatments comprising RF ablation followed by injection of polymethylmethacrylate cement performed in 19 patients during a 22-month period. Patients ranged in age from 42 to 82 years (mean, 58.9 years) and included five women and 14 men. Eleven vertebrae (eight lumbar and three thoracic), nine acetabulae, three sacra, one pubis, and one humerus were treated with a total of 36 RF ablations (in several instances, overlapping ablations were used). The location of the primary neoplasm, lesion size, pain before and after the procedure (as determined with a 10-point visual analog scale [VAS]), number of RF treatments, type of device used for cementoplasty, RF time, cement volume, and extravasation were documented.
Results
A total of 25 combined RF ablations and cementoplasties were performed. The technical success rate was 100% (25 of 25 treatments). There were seven minor complications: six limited cement extravasations and a transient thermal nerve injury. The mean RF time was 9.1 minutes (range, 6–12 minutes). The mean cement volume injected was 6.1 mL (range, 0.8–16 mL). The mean preprocedure pain (as measured with a VAS) was 7.9 (range, 7.0–9.0) and the mean posttreatment pain was 4.2 (range, 0–6); the difference was statistically significant (mean score, 4.08; 95% confidence interval: 3.92, 4.87; P < .0001) using a paired t test.
Conclusions
Combined RF ablation and cementoplasty appears to be safe and effective in the treatment of painful neoplastic lesions of bone.
aDepartment of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BCV52 1M9 Canada
bDepartment of Internal Medicine, Division of Rheumatology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BCV52 1M9 Canada
cDepartment of Orthopedic Surgery, University of British Columbia, Vancouver General Hospital and British Columbia Cancer Agency
Address correspondence to P.L.M.
From the 2008 SIR annual meeting.
None of the authors have identified a conflict of interest.
ABSTRACT