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Comparison of post-operative pain scores and opioid use between kyphoplasty and radiofrequency ablation (RFA) systems combined with cement augmentation

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Abstract

Objective

This retrospective chart review study aims to compare demographic information, post-operative pain scores, and opioid use following treatment with kyphoplasty alone, OsteoCool™ (Medtronic) system, and SpineSTAR ® (Merit Medicine).

Materials and methods

Following institutional review board approval, retrospective chart review of 64 patients was examined between January 2011 and December 2017. Inclusion criteria for this study comprised patients greater than 18 years old having metastatic vertebral compression fracture involving the thoracolumbar spine. Exclusion criteria consisted of non-pathologic osteoporotic compression fractures, metastasis in cervical spine, or previous radiofrequency ablation (RFA) treatment. Age at intervention, gender, previous treatment, and nursing recorded VAS score from 0 to 10, with zero representing no pain and 10 representing worst pain were compared. Pain scores documented immediately pre- and post-operatively, as well as 7–14 days post-operatively were targeted for analysis. Post-procedure opioid intake during the first month following surgery was also assessed.

Results

A total of 63 patients were included in this retrospective analysis. The demographic characteristics between the treatment arms were similar. Difference of square means analysis showed no statistical difference in pain scores at each time interval between the two RFA systems, or was there a statistical difference in pain scores when each RFA system was compared independently to kyphoplasty alone. Chi-squared analysis showed no statistical difference in opioid use between the treatment arms 1 month post-operatively.

Discussion

To our knowledge, this is the first study that evaluates post-operative pain scores between the two novel RFA systems and kyphoplasty alone. Each system results in improved pain scores post-operatively; however, no additional benefit was seen from the addition of RFA.

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References

  1. Kurup AN, Callstrom MR. Ablation of skeletal metastases: current status. J Vasc Interv Radiol. 2010;21(8 Suppl):S242–50.

    Article  PubMed  Google Scholar 

  2. Lipton A. New approaches to treating and preventing bone metastases. Curr Opin Support Palliat Care. 2010;4(3):178–81.

    PubMed  Google Scholar 

  3. Pezeshki PS, Woo J, Akens MK, et al. Evaluation of a bipolar-cooled radiofrequency device for ablation of bone metastases: preclinical assessment in porcine vertebrae. Spine J. 2014;14(2):361–70.

    Article  PubMed  Google Scholar 

  4. Ontario HQ. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: a systematic review. Ontario Health Technol Assess Series. 2016;16(11):1.

    Google Scholar 

  5. Marcia S, Saba L, Marras M, Suri JS, Calabria E, Masala S. Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain. Br J Radiol. 2016;89(1065):20150436.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Marcia S, Muto M, Hirsch JA, et al. What is the role of vertebral augmentation for osteoporotic fractures? A review of the recent literature. Neuroradiology. 2018;60(8):777–83.

    Article  PubMed  Google Scholar 

  7. Witham TF, Khavkin YA, Gallia GL, Wolinsky JP, Gokaslan ZL. Surgery insight: current management of epidural spinal cord compression from metastatic spine disease. Nat Clin Pract Neurol. 2006;2(2):87–94.

    Article  PubMed  Google Scholar 

  8. Fourney DR, Schomer DF, Nader R, et al. Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg. 2003;98(1 Suppl):21–30.

    PubMed  Google Scholar 

  9. Pezeshki PS, Davidson S, Murphy K, et al. Comparison of the effect of two different bone-targeted radiofrequency ablation (RFA) systems alone and in combination with percutaneous vertebroplasty (PVP) on the biomechanical stability of the metastatic spine. Eur Spine J. 2016;25(12):3990–6.

    Article  PubMed  Google Scholar 

  10. Anchala PR, Irving WD, Hillen TJ, et al. Treatment of metastatic spinal lesions with a navigational bipolar radiofrequency ablation device: a multicenter retrospective study. Pain Physician. 2014;17(4):317–27.

    PubMed  Google Scholar 

  11. Hillen TJ, Anchala P, Friedman MV, Jennings JW. Treatment of metastatic posterior vertebral body osseous tumors by using a targeted bipolar radiofrequency ablation device: technical note. Radiology. 2014;273(1):261–7.

    Article  PubMed  Google Scholar 

  12. Bagla S, Sayed D, Smirniotopoulos J, et al. Multicenter prospective clinical series evaluating radiofrequency ablation in the treatment of painful spine metastases. Cardiovasc Intervent Radiol. 2016;39(9):1289–97.

    Article  PubMed  Google Scholar 

  13. Wallace A, Tomasian A, Vaswani D, Vyhmeister R, Chang R, Jennings J. Radiographic local control of spinal metastases with percutaneous radiofrequency ablation and vertebral augmentation. Am J Neuroradiol. 2016;37:759–65.

    Article  CAS  PubMed  Google Scholar 

  14. Rendon RA, Kachura JR, Sweet JM, et al. The uncertainty of radio frequency treatment of renal cell carcinoma: findings at immediate and delayed nephrectomy. J Urol. 2002;167:1587–92.

    Article  PubMed  Google Scholar 

  15. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153–7.

    Article  CAS  PubMed  Google Scholar 

  16. Halpin RJ, Bendok BR, Sato KT, Liu JC, Patel JD, Rosen ST. Combination treatment of vertebral metastases using image-guided percutaneous radiofrequency ablation and vertebroplasty: a case report. Surg Neurol. 2005;63(5):469–74.

    Article  PubMed  Google Scholar 

  17. Kam NM, Maingard J, Kok HK, et al. Combined vertebral augmentation and radiofrequency ablation in the management of spinal metastases: an update. Curr Treat Options in Oncol. 2017;18(12):74.

    Article  Google Scholar 

  18. Vogl TJ, Pflugmacher R, Hierholzer J, et al. Cement directed kyphoplasty reduces cement leakage as compared with vertebroplasty: results of a controlled, randomized trial. Spine. 2013;38(20):1730–6.

    Article  PubMed  Google Scholar 

  19. Berenson J, Pflugmacher R, Jarzem P, et al. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. Lancet Oncol. 2011;12(3):225–35.

    Article  PubMed  Google Scholar 

  20. Dupuy DE, Hong R, Oliver B, Goldberg SN. Radiofrequency ablation of spinal tumors: temperature distribution in the spinal canal. Am J Roentgenol. 2000;175(5):1263–6.

    Article  CAS  Google Scholar 

  21. Goetz MP, Callstrom MR, Charboneau JW, et al. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol. 2004;22(2):300–6.

    Article  PubMed  Google Scholar 

  22. Rosian K, Hawlik K, Piso B. Efficacy assessment of radiofrequency ablation as a palliative pain treatment in patients with painful metastatic spinal lesions: a systematic review. Pain Physician. 2018;21(5):E467–76.

    Article  PubMed  Google Scholar 

  23. Orgera G, Krokidis M, Matteoli M, et al. Percutaneous vertebroplasty for pain management in patients with multiple myeloma: is radiofrequency ablation necessary? Cardiovasc Intervent Radiol. 2014;37(1):203–10.

    Article  PubMed  Google Scholar 

  24. Lane MD, Le HB, Lee S, et al. Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients. Skelet Radiol. 2011;40(1):25–32.

    Article  Google Scholar 

  25. Munk PL, Rashid F, Heran MK, et al. Combined cementoplasty and radiofrequency ablation in the treatment of painful neoplastic lesions of bone. J Vasc Interv Radiol. 2009;20(7):903–11.

    Article  PubMed  Google Scholar 

  26. Sandri A, Carbognin G, Regis D, et al. Combined radiofrequency and kyphoplasty in painful osteolytic metastases to vertebral bodies. Radiol Med. 2010;115:261–71.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Chicago, Chicago, USA

    Sumit Jain, Logan Kinch, Maunak Rana & Magdalena Anitescu

  2. University of Virginia, Charlottesville, USA

    Logan Kinch

Authors
  1. Sumit Jain
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  2. Logan Kinch
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  3. Maunak Rana
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  4. Magdalena Anitescu
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Correspondence to Sumit Jain.

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The study was approved by the hospital institutional review board.

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The authors declare that they have no conflict of interest.

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Jain, S., Kinch, L., Rana, M. et al. Comparison of post-operative pain scores and opioid use between kyphoplasty and radiofrequency ablation (RFA) systems combined with cement augmentation. Skeletal Radiol 49, 1789–1794 (2020). https://doi.org/10.1007/s00256-020-03473-1

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  • DOI: https://doi.org/10.1007/s00256-020-03473-1

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