Skeletal Radiology

, Volume 40, Issue 1, pp 25–32 | Cite as

Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients

  • Michael David Lane
  • Huy B. Q. Le
  • Steven Lee
  • Casey Young
  • Manraj K. S. Heran
  • Maziar Badii
  • Paul William Clarkson
  • Peter L. Munk
Scientific Article

Abstract

Objective

We report the safety and efficacy of combined radiofrequency ablation and cementoplasty in treating painful neoplastic bone lesions.

Materials and Methods

Fifty-three combined radiofrequency ablation and cementoplasty procedures were completed in 36 patients. Thirty-four vertebrae (20 lumbar, 14 thoracic), 14 acetabulae, 3 sacra, 1 pubic symphysis, and 1 humerus were treated. Patient age ranged from 34 to 81 years (mean 57.6 years, SD = 12.6). Primary malignancies included: 12 breast, 5 lung, 6 multiple myeloma, 2 prostate, 2 renal cell carcinoma, 1 synovial sarcoma, 1 endometrial, 1 oral squamous cell carcinoma, 1 lymphoma, 1 colon, 1 transitional cell carcinoma, 1 colorectal, 1 cholangiocarcinoma, and 1 pheochromocytoma. Primary neoplasm location, pain levels pre- and post-procedure (as assessed using the Visual Analog Scale), number of radiofrequency (RF) treatments and any extravasation were documented.

Results

Combined radiofrequency ablation (RFA) and cementoplasty procedures were performed with 100% technical success (53 out of 53). The mean pre-procedure and post-procedure pain, as measured by the Visual Analog Scale (VAS), was 7.2/10 and 3.4/10 respectively. Symptomatic complications included one case of self-resolving transient thermal sciatic neurapraxia following RFA and acetabuloplasty. Two cases of transient pain following epidural leaks during treatment of thoracic vertebrae and breast metastases also occurred. Non-symptomatic complications, from a variety of cases, included cement emboli to the lung, incidental, non-symptomatic leaks into the needle track, spinal canal, draining veins, disc spaces, and an intra-articular leak into the hip joint.

Conclusion

Combined RFA and cementoplasty appears to be safe, practical and effective in the palliative treatment of painful neoplastic lesions.

Keywords

Painful bone metastasis Radiofrequency ablation Cementoplasty Palliative care 

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Copyright information

© ISS 2010

Authors and Affiliations

  • Michael David Lane
    • 1
  • Huy B. Q. Le
    • 1
  • Steven Lee
    • 1
  • Casey Young
    • 1
  • Manraj K. S. Heran
    • 1
  • Maziar Badii
    • 2
  • Paul William Clarkson
    • 3
  • Peter L. Munk
    • 1
  1. 1.Department of Radiology, Vancouver General HospitalUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Internal Medicine, Division of Rheumatology, Vancouver General HospitalUniversity of British ColumbiaVancouverCanada
  3. 3.Department of OrthopaedicsUniversity of British ColumbiaVancouverCanada

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