Tumor ablation and vertebral augmentation in the treatment of vertebral metastases. A multicenter study
Matías Alfonso 1 , Rafael Llombart 2 , Lara Gil 2 , Isabel Martinez 2 , Claudio Rodríguez 3 , Luis Álvarez 4 , Jesús Gallego 4
Introduction: Treatment of metastatic vertebral fractures without neural compression is performed with percutaneous cementation techniques. The increase in intratumoral pressure by these techniques can send tumor cells into the bloodstream. To prevent this dissemination and improve pain treatment, ablation techniques have been introduced that would allow the creation of a cavity in the tumor prior to cementation or directly necrosing the metastasis when its size is small.
Material: We present the experience with ablation of 2 hospitals and two different ablation techniques. The first group used radiofrequency ablation (A) in 14 patients (26 vertebrae), 4 of whom underwent vertebral arthrodesis. The second group used microwave ablation(B) in 93 patients (129 lesions) without associated vertebral instrumentation.
Results: In group A pain improvement in VAS was 7.7 to 2.6 at 6 weeks. There were no complications derived from the ablation. In most cases cementation was associated. In the group B pain improvement in VAS went from 6.8 to 1.7 at 6 weeks. Cementation was associated in all cases. There were no complications derived from the ablation.
Conclusion: The association of ablation techniques with vertebral cementation is a safe technique that significantly improves the patient's pain and can help control the disease.