Low-power bipolar radiofrequency ablation and vertebral augmentation for the palliative treatment of spinal malignancies

Abstract

Aim: To investigate the analgesic properties and the safety of low power bipolar radiofrequency ablation (RFA) performed with internally cooled electrodes and vertebral augmentation for the treatment of painful spinal malignancies. Materials and methods: Consent was waived for retrospective study participation. Review of electronic records identified 11 consecutive patients (6 females; 5 males; mean age 61.3 ± 11.6 years) with one-index painful spinal tumour, who were treated between June 2016 and October 2017 with bipolar RFA and vertebral augmentation. Patients were treated if they presented with focal pain (≥4/10 on a 0–10 visual analogic scale in the 24-h period) corresponding to a metastatic vertebral level on cross sectional imaging. The Wilcoxon test was used to evaluate the significance of the post-operative pain. Results: Lumbar levels were treated in 72.7% cases; metastatic epidural involvement was noted in 81.8% cases; 54.5% patients received associated treatments in addition to RFA, which was coupled to vertebral augmentation in all cases. Two (18.2%) complications were noted. Mean pain score measured at last clinical follow-up available (mean 1.9 ± 1.4 months) was 3.5 ± 2 (versus 7.8 ± 1.1 at baseline; p <0.01). Conclusions: Low-power bipolar RFA performed with internally cooled electrodes and coupled to vertebral augmentation provides safe and effective early analgesia in patients affected by painful spinal malignancies.