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Current Treatment Options in Oncology
Published in: Current Treatment Options in Oncology 12/2017

01-12-2017 | Neuro-oncology (GJ Lesser, Section Editor)

Combined Vertebral Augmentation and Radiofrequency Ablation in the Management of Spinal Metastases: an Update

Authors: Ning Mao Kam, MD, Julian Maingard, MBBS, Hong Kuan Kok, FFRRCSI, FRCR, EBIR, Dinesh Ranatunga, FRANZCR, EBIR, Duncan Brooks, FRANZCR, CCINR, EBIR, William C. Torreggiani, FFRRCSI, FRCR, Peter L. Munk, FRCPC, FSIR, Michael J. Lee, FFRRCSI, FRCR, EBIR, FSIR, Ronil V. Chandra, FRANZCR, CCINR, Hamed Asadi, FRANZCR, CCINR, EBIR

Published in: Current Treatment Options in Oncology | Issue 12/2017

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Opinion statement

Spinal metastases are the most commonly encountered tumour of the spine, occurring in up to 40% of patients with cancer. Each year, approximately 5% of cancer patients will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with spinal metastases experience severe and frequently debilitating pain, which often decreases their remaining quality of life. With a median survival of less than 1 year, the goals of treatment in spinal metastases are reducing pain, improving or maintaining level of function and providing mechanical stability. Currently, conventional treatment strategies involve a combination of analgesics, bisphosphonates, radiotherapy and/or relatively extensive surgery. Despite these measures, pain management in patients with spinal metastases is often suboptimal. In the last two decades, minimally invasive percutaneous interventional radiology techniques such as vertebral augmentation and radiofrequency ablation (RFA) have shown progressive success in reducing pain and improving function in many patients with symptomatic spinal metastases. Both vertebral augmentation and RFA are increasingly being recognised as excellent alternative to medical and surgical management in carefully selected patients with spinal metastases, namely those with severe refractory pain limiting daily activities and stable pathological vertebral compression fractures. In addition, for more complicated lesions such as spinal metastasis with soft tissue extension, combined treatments such as vertebral augmentation in conjunction with RFA may be helpful. While combined RFA and vertebral augmentation have theoretical benefits, comparative trials have not been performed to establish superiority of combined therapy. We believe that a multidisciplinary approach as well as careful pre-procedure evaluation and imaging will be necessary for effective and safe management of spinal metastases. RFA and vertebral augmentation should be considered during early stages of the disease so as to maintain the remaining quality of life in this patient population group.
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Metadata
Title
Combined Vertebral Augmentation and Radiofrequency Ablation in the Management of Spinal Metastases: an Update
Authors
Ning Mao Kam, MD
Julian Maingard, MBBS
Hong Kuan Kok, FFRRCSI, FRCR, EBIR
Dinesh Ranatunga, FRANZCR, EBIR
Duncan Brooks, FRANZCR, CCINR, EBIR
William C. Torreggiani, FFRRCSI, FRCR
Peter L. Munk, FRCPC, FSIR
Michael J. Lee, FFRRCSI, FRCR, EBIR, FSIR
Ronil V. Chandra, FRANZCR, CCINR
Hamed Asadi, FRANZCR, CCINR, EBIR
Publication date
01-12-2017
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 12/2017
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-017-0516-7

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