Angelos N Gazis1, Oliver Beuing2, Jörg Franke3, Boris Jöllenbeck4, Martin Skalej2. 1. Institute of Neuroradiology, University Hospital of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany. Electronic address: angelos.gazis@med.ovgu.de. 2. Institute of Neuroradiology, University Hospital of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany. 3. Department of Orthopedics, University Hospital of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany. 4. Department of Neurosurgery, University Hospital of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.
Abstract
BACKGROUND: Bone metastases are often the cause of tumor-associated pain and reduction of quality of life. For patients that cannot be treated by surgery, a local minimally invasive therapy such as radiofrequency ablation can be a useful option. In cases in which tumorous masses are adjacent to vulnerable structures, the monopolar radiofrequency can cause severe neuronal damage because of the unpredictability of current flow. PURPOSE: The aim of this study is to show that the bipolar radiofrequency ablation provides an opportunity to safely treat such spinal lesions because of precise predictability of the emerging ablation zone. STUDY DESIGN: Prospective cohort study of 36 patients undergoing treatment at a single institution. PATIENT SAMPLE: Thirty-six patients in advanced tumor stage with primary or secondary tumor involvement of spine undergoing radiofrequency ablation. OUTCOME MEASURES: Prediction of emerging ablation zone. Clinical outcome of treated patients. METHODS: X-ray-controlled treatment of 39 lesions by bipolar radiofrequency ablation. Magnetic resonance imaging was performed pre- and postinterventionally. Patients were observed clinically during their postinterventional stay. RESULTS: The extent of the ablation zones was predictable to the millimeter because it did not cross the peri-interventional planned dorsal and ventral boundaries in any case. No complications were observed. CONCLUSIONS: Ablation of tumorous masses adjacent to vulnerable structures is feasible and predictable by using the bipolar radiofrequency ablation. Damage of neuronal structures can be avoided through precise prediction of the ablation area.
BACKGROUND: Bone metastases are often the cause of tumor-associated pain and reduction of quality of life. For patients that cannot be treated by surgery, a local minimally invasive therapy such as radiofrequency ablation can be a useful option. In cases in which tumorous masses are adjacent to vulnerable structures, the monopolar radiofrequency can cause severe neuronal damage because of the unpredictability of current flow. PURPOSE: The aim of this study is to show that the bipolar radiofrequency ablation provides an opportunity to safely treat such spinal lesions because of precise predictability of the emerging ablation zone. STUDY DESIGN: Prospective cohort study of 36 patients undergoing treatment at a single institution. PATIENT SAMPLE: Thirty-six patients in advanced tumor stage with primary or secondary tumor involvement of spine undergoing radiofrequency ablation. OUTCOME MEASURES: Prediction of emerging ablation zone. Clinical outcome of treated patients. METHODS: X-ray-controlled treatment of 39 lesions by bipolar radiofrequency ablation. Magnetic resonance imaging was performed pre- and postinterventionally. Patients were observed clinically during their postinterventional stay. RESULTS: The extent of the ablation zones was predictable to the millimeter because it did not cross the peri-interventional planned dorsal and ventral boundaries in any case. No complications were observed. CONCLUSIONS: Ablation of tumorous masses adjacent to vulnerable structures is feasible and predictable by using the bipolar radiofrequency ablation. Damage of neuronal structures can be avoided through precise prediction of the ablation area.
Authors: Khaled Madani; Arash Najafi; Angela Boticella; Charles Roux; Lambros Tselikas; Alexandre Delpla; Marc Al Ahmar; Thierry de Baere; Frédéric Deschamps Journal: Support Care Cancer Date: 2021-07-21 Impact factor: 3.603