Sandeep Bagla1, Dawood Sayed2, John Smirniotopoulos3, Jayson Brower4, J Neal Rutledge5, Bradley Dick6, James Carlisle7, Ilya Lekht8, Bassem Georgy9. 1. Vascular Institute of Virginia, LLC, 14085 Crown Ct., Woodbridge, VA, 22193, USA. sandeep.bagla@gmail.com. 2. University of Kansas Medical Center, Kansas City, KS, USA. 3. New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA. 4. Providence Sacred Heart Medical Center and Children's Hospital, Spokane, WA, USA. 5. Seton Medical Center, Austin, TX, USA. 6. Suburban Hospital, Bethesda, MD, USA. 7. St. Mark's Hospital, Salt Lake City, UT, USA. 8. University of Southern California, Los Angeles, CA, USA. 9. San Diego Imaging, San Diego, CA, USA.
Abstract
BACKGROUND: Radiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM. METHODS: Fifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval. RESULTS: Twenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported. CONCLUSION: RFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.
BACKGROUND: Radiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM. METHODS: Fifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval. RESULTS: Twenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported. CONCLUSION: RFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.
Authors: Dimitrios K Filippiadis; Steven Yevich; Frederic Deschamps; Jack W Jennings; Sean Tutton; Alexis Kelekis Journal: Curr Oncol Rep Date: 2019-11-25 Impact factor: 5.075
Authors: David Hao; Shawn Sidharthan; Juan Cotte; Mary Decker; Mariam Salisu-Orhurhu; Dare Olatoye; Jay Karri; Jonathan M Hagedorn; Peju Adekoya; Charles Odonkor; Amitabh Gulati; Vwaire Orhurhu Journal: Curr Pain Headache Rep Date: 2021-05-07