Padina S Pezeshki1,2, Sean Davidson3, Kieran Murphy1,3, Claire McCann2, Elzbieta Slodkowska2, Michael Sherar1,3, Albert Jm Yee1,2, Cari M Whyne4,5. 1. University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada. 2. Sunnybrook Research Institute, 2075 Bayview Ave., Room S620, Toronto, ON, M4N 3M5, Canada. 3. Techna Institute, University Health Network, 124-100 College Street, Toronto, ON, M5G 1P5, Canada. 4. University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada. cari.whyne@sunnybrook.ca. 5. Sunnybrook Research Institute, 2075 Bayview Ave., Room S620, Toronto, ON, M4N 3M5, Canada. cari.whyne@sunnybrook.ca.
Abstract
INTRODUCTION: Radiofrequency ablation (RFA) and percutaneous vertebroplasty (PVP) are used independently and in combination to treat metastatically involved vertebrae with the aim of relieving pain, reducing tumour burden and providing bony mechanical stabilization. PURPOSE: The aim of this work was to characterize the effect of two bone-targeted RFA devices, alone and in combination with PVP, to improve strength and mechanical stability in vertebrae with osteolytic metastatic disease. METHODS: Simulated spinal metastases (n = 12) were treated with one of two bone-targeted RFA devices (bipolar cooled or bone coil RF electrodes), followed by PVP. Under axial compressive loading, spinal canal narrowing was measured in the intact specimen, after tumour simulation, post-RFA and post-PVP. RESULTS: RFA alone resulted in successful tumour shrinkage and cavitation, but further increased canal narrowing under loading. RFA combined with PVP significantly reduced posterior wall stability in samples where sufficient tumour shrinkage and cavitation were coupled with a pattern of cement deposition which extended to posterior vertebral body. CONCLUSIONS: RFA combined with cement deposition in the posterior vertebral body demonstrates significantly more stable vertebrae under axial loading.
INTRODUCTION: Radiofrequency ablation (RFA) and percutaneous vertebroplasty (PVP) are used independently and in combination to treat metastatically involved vertebrae with the aim of relieving pain, reducing tumour burden and providing bony mechanical stabilization. PURPOSE: The aim of this work was to characterize the effect of two bone-targeted RFA devices, alone and in combination with PVP, to improve strength and mechanical stability in vertebrae with osteolytic metastatic disease. METHODS: Simulated spinal metastases (n = 12) were treated with one of two bone-targeted RFA devices (bipolar cooled or bone coil RF electrodes), followed by PVP. Under axial compressive loading, spinal canal narrowing was measured in the intact specimen, after tumour simulation, post-RFA and post-PVP. RESULTS: RFA alone resulted in successful tumour shrinkage and cavitation, but further increased canal narrowing under loading. RFA combined with PVP significantly reduced posterior wall stability in samples where sufficient tumour shrinkage and cavitation were coupled with a pattern of cement deposition which extended to posterior vertebral body. CONCLUSIONS: RFA combined with cement deposition in the posterior vertebral body demonstrates significantly more stable vertebrae under axial loading.
Authors: Zhengjun Liu; S Melvyn Lobo; Stanley Humphries; Clare Horkan; Stephanie A Solazzo; Andrew U Hines-Peralta; Robert E Lenkinski; S Nahum Goldberg Journal: AJR Am J Roentgenol Date: 2005-04 Impact factor: 3.959
Authors: Padina S Pezeshki; Sean R Davidson; Margarete K Akens; Kieran Murphy; Claire McCann; Michael Sherar; Cari M Whyne; Albert J M Yee Journal: Spine J Date: 2015-03-24 Impact factor: 4.166
Authors: Padina S Pezeshki; Jason Woo; Margarete K Akens; John E Davies; Michael Gofeld; Cari M Whyne; Albert J M Yee Journal: Spine J Date: 2013-11-22 Impact factor: 4.166