Radiofrequency Ablation Combined With Percutaneous Vertebroplasty For The Treatment Of Spinal Metastasis

Objective:The purpose for this study was to use radiofrequency ablation in combination with percutaneous vertebroplasty treating spinal metastasi s and evaluating its clinical outcomes,stability of treatment.So it could provide a potential reference for clinically relevant treatment of spinal metastasis.Methods:Analysing 55 patients suffering spinal metastasis from October 2011 to December 2015 retrospectively.28 patients were treated through percutaneous vertebroplasty(PVP group).The rest were chosen percutaneous vertebroplasty combined with radiofrequency ablation(RFA+PVP group).The PVP group consisted of 19 men and 9 women with a mean age of 47.04±8.53 years.Similarly,there were 20 men and 7 women in RFA+PVP group,which has a mean age of 49.04±7.57 years.The cervical,thoracic,lumbar and sacrum were all involved in two groups.The clinical outcomes were assessed by visual analogue scale(VAS)and Karnofsky(KPS).Recorded data also included the percentage of bone cement leakage and tumor relapsing rates.Survival analysis was evaluated by Kaplan-meier.Results:With the follow-up of 18 months,the VAS score improved at 6 months after their operations in both groups(from 7.86±0.85 to 3.07±0.90 for Group PVP,and from 7.67±0.96 to 2.96±0.94 for Group RFA+PVP).All patients pain were in relief,but there were no significant differences in two groups at 6 months postoperatively(t=0.437,P=0.664).This was also the same as 1 month.Mean KPS in two groups both increased after surgery,not only at 1 month,but also at 6 months.But no significant differences were found between the two groups(At 1 month:?2=0.0457,P=0.831;At 6 months:?2=0.022,P=0.883).The percentage of bone cement leakage rate in PVP group was 42.86%and RFA+PVP group was 11.11%.As for the percentage of tumor relapsing rate,PVP group accounted for 32.14%and 7.41%for RFA+PVP group respectively.There had significant differences in two groups,including the percentage of bone cement leakage and tumor relapsing rate.The median survival time of PVP group was 12 months and 13 months in RFA+PVP group.The survival time was similar in two groups after operation.No significant differences were showed between the two groups(?2=0.087,P=0.768,Log-rank).Conclusion:The treatment for spinal metastasis by radiofrequency ablation in combination with percutaneous vertebroplasty not only got similar effects with simple percutaneous vertebroplasty,but also could reduce bone cement extravasation to a certain extent and control the progress of tumor early after operation.