Skip to main content

Advertisement

SpringerLink
Log in

Percutaneous bipolar radiofrequency ablation for spine metastatic lesions

  • General Review
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this review is to become familiar with the most common indications for imaging guided percutaneous bipolar radiofrequency ablation, to learn about different technical considerations during performance providing the current evidence. Controversies concerning products will be addressed.

Methods

We performed a literature review excluding non-English studies and case reports. All references of the obtained articles were also evaluated for any additional information.

Results

RFA achieves cytotoxicity by raising target area temperatures above 60 °C, and may be used to achieve total necrosis of lesions smaller than 3 cm in diameter, to debulk and reduce the pain associated with larger lesions, to prevent pathological fractures due to progressive osteolysis or for cavity creation aiming for targeted cement delivery in case of posterior vertebral wall breaching. Protective ancillary techniques should be used in order to increase safety and augment efficacy of RFA in the spine.

Conclusion

Percutaneous radiofrequency ablation of vertebral lesions is a reproducible, successful and safe procedure. Ablation should be combined with vertebral augmentation in all cases. In order to optimize maximum efficacy a patient- and a lesion-tailored approach should both be offered focusing upon clinical and performance status along with life expectancy of the patient as well as upon lesion characteristics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Harel R, Angelov L (2010) Spine metastases: current treatments and future directions. Eur J Cancer 46(15):2696–2707

    PubMed  Google Scholar 

  2. Shah LM, Salzman KL (2011) Imaging of spinal metastatic disease. Int J Surg Oncol. https://doi.org/10.1155/2011/769753

    Article  PubMed  PubMed Central  Google Scholar 

  3. Choi D, Crockard A, Bunger C et al (2010) Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the Global Spine Tumour Study Group. Eur Spine J 19(2):215–222

    PubMed  Google Scholar 

  4. Ha KY, Kim YH, Yoo TW (2013) Intraoperative radiofrequency ablation for metastatic spine disease: report of 4 cases and review. Eur J Orthop Surg Traumatol 23(2):S129–S134

    PubMed  Google Scholar 

  5. Vazifehdan F, Karantzoulis VG, Igoumenou VG (2017) Surgical treatment for metastases of the cervical spine. Eur J Orthop Surg Traumatol 27(6):763–775

    PubMed  Google Scholar 

  6. Igoumenou VG, Mavrogenis AF, Angelini A, Baracco R, Benzakour A, Benzakour T, Bork M, Vazifehdan F, Nena U, Ruggieri P (2020) Complications of spine surgery for metastasis. Eur J Orthop Surg Traumatol 30(1):37–56

    PubMed  Google Scholar 

  7. Filippiadis DK, Tutton S, Mazioti A et al (2014) Percutaneous image-guided ablation of bone and soft tissue tumours: a review of available techniques and protective measures. Insights Imaging 5:339–346

    PubMed  PubMed Central  Google Scholar 

  8. Ruiz Santiago F, Castellano García MM, Guzmán Álvarez L et al (2011) Percutaneous treatment of bone tumors by radiofrequency thermal ablation. Eur J Radiol 77:156–163

    PubMed  Google Scholar 

  9. Santiago FR, Kelekis A, Alvarez LG, Filippiadis DK (2014) Interventional procedures of the spine. Semin Musculoskelet Radiol 18(3):309–317

    PubMed  Google Scholar 

  10. Hong K, Georgiades CS (2011) Radiofrequency ablation: mechanism of action and devices. In: Hong K, Georgiades CS (eds) Percutaneous tumor ablation strategies and techniques. Thieme Medical Publishers, New York, pp 1–14

    Google Scholar 

  11. Rosenthal DI, Alexander A, Rosenberg AE, Springfield D (1992) Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 183(1):29–33

    CAS  PubMed  Google Scholar 

  12. Buy X, Basile A, Bierry G, Cupelli J, Gangi A (2006) Saline-infused bipolar radiofrequency ablation of high-risk spinal and paraspinal neoplasms. AJR Am J Roentgenol 186(5 Suppl):S322–S326

    PubMed  Google Scholar 

  13. Gangi A, Tsoumakidou G, Buy X, Quoix E (2010) Quality improvement guidelines for bone tumour management. Cardiovasc Intervent Radiol 33(4):706–713

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Hillen TJ, Anchala P, Friedman MV, Jennings JW (2014) Treatment of metastatic posterior vertebral body osseous tumors by using a targeted bipolar radiofrequency ablation device: technical note. Radiology 273(1):261–267

    PubMed  Google Scholar 

  15. Wallace AN, Robinson CG, Meyer J, Tran ND, Gangi A, Callstrom MR, Chao ST, Van Tine BA, Morris JM, Bruel BM, Long J, Timmerman RD, Buchowski JM, Jennings JW (2015) The metastatic spine disease multidisciplinary working group algorithms. Oncologist 20(10):1205–1215

    PubMed  PubMed Central  Google Scholar 

  16. Tokuhashi Y, Uei H, Oshima M et al (2014) Scoring system for prediction of metastatic spine tumor prognosis. World J Orthop 5(3):262–271

    PubMed  PubMed Central  Google Scholar 

  17. Tomita K, Kawahara N, Kobayashi T et al (2001) Surgical strategy for spinal metastases. Spine 26(3):298–306

    CAS  PubMed  Google Scholar 

  18. Mystakidou K, Mendoza T, Tsilika E, Befon S, Parpa E, Bellos G, Vlahos L, Cleeland C (2001) Greek brief pain inventory: validation and utility in cancer pain. Oncology 60(1):35–42

    CAS  PubMed  Google Scholar 

  19. Fourney DR, Frangou EM, Ryken TC et al (2011) Spinal instability neoplastic score: an analysis of reliability and validity from the spine oncology study group. J Clin Oncol 29(22):3072–3077

    PubMed  Google Scholar 

  20. Kurup AN, Schmit GD, Morris JM, Atwell TD, Schmitz JJ, Weisbrod AJ, Woodrum DA, Eiken PW, Callstrom MR (2017) Avoiding complications in bone and soft tissue ablation. Cardiovasc Intervent Radiol 40(2):166–176

    PubMed  Google Scholar 

  21. Garnon J, Cazzato RL, Caudrelier J, Nouri-Neuville M, Rao P, Boatta E, Ramamurthy N, Koch G, Gangi A (2019) Adjunctive thermoprotection during percutaneous thermal ablation procedures: review of current techniques. Cardiovasc Intervent Radiol 42(3):344–357

    PubMed  Google Scholar 

  22. Yoon JT, Nesbitt J, Raynor BL, Roth M, Zertan CC, Jennings JW (2020) Utility of motor and somatosensory evoked potentials for neural thermoprotection in ablations of musculoskeletal tumors. J Vasc Interv Radiol 31(6):903–911

    PubMed  Google Scholar 

  23. Filippiadis DK, Tutton S, Kelekis A (2014) Percutaneous bone lesion ablation. Radiol Med 119:462–469

    PubMed  Google Scholar 

  24. Callstrom MR, Charboneau JW, Goetz MP et al (2002) Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiol 224:87–97

    Google Scholar 

  25. Goetze MP, Callstrom MR, Charboneau JW et al (2004) Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 22:300–306

    Google Scholar 

  26. Dupuy DE, Liu D, Hartfeil D et al (2010) Percutaneous radiofrequency ablation of painful osseous metastases. Cancer 116(4):989–997

    PubMed  Google Scholar 

  27. Anchala PR, Irving WD, Hillen TJ et al (2014) Treatment of metastatic spinal lesions with a navigational bipolar radiofrequency ablation device: a multicenter retrospective study. Pain Physician 17(4):317–327

    PubMed  Google Scholar 

  28. Bagla S, Sayed D, Smirniotopoulos J et al (2016) Multicenter prospective clinical series evaluating radiofrequency ablation in the treatment of painful spine metastases. Cardiovasc Intervent Radiol 39:1289–1297

    PubMed  Google Scholar 

  29. Levy J, Hopkins T, Morris J, Tran ND, David E, Massari F, Farid H, Vogel A, O’Connell WG, Sunenshine P, Dixon R, Gangi A, von der Höh N, Bagla S (2020) Radiofrequency ablation for the palliative treatment of bone metastases: outcomes from the multicenter osteocool tumor ablation post-market study (OPuS One Study) in 100 patients. J Vasc Interv Radiol 31(11):1745–1752

    PubMed  Google Scholar 

  30. Mayer T, Cazzato RL, De Marini P, Auloge P, Dalili D, Koch G, Garnon J, Gangi A (2021) Spinal metastases treated with bipolar radiofrequency ablation with increased (>70 °C) target temperature: Pain management and local tumor control. Diagn Interv Imaging 102(1):27–34

    CAS  PubMed  Google Scholar 

  31. Tomasian A, Hillen TJ, Chang RO, Jennings JW (2018) Simultaneous bipedicular radiofrequency ablation combined with vertebral augmentation for local tumor control of spinal metastases. AJNR Am J Neuroradiol 39(9):1768–1773

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Swarm RA, Paice JA, Anghelescu DL, Are M, Bruce JY, Buga S, Chwistek M, Cleeland C, Craig D, Gafford E, Greenlee H, Hansen E, Kamal AH, Kamdar MM, LeGrand S, Mackey S, McDowell MR, Moryl N, Nabell LM, BCPS SN, O'Connor N, Rabow MW, Rickerson E, Shatsky R, Sindt J, Urba SG, Youngwerth JM, Hammond LJ, Gurski LA (2019) Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl ComprCanc Netw 17(8):977–1007

    CAS  Google Scholar 

  33. .Lutz S, Berk L, Chang E, et al (2011) Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys 79(4):965–976

    Google Scholar 

  34. Dennis K, Makhani L, Zeng L et al (2013) Single fraction conventional external beam radiation therapy for bone metastases: a systematic review of randomised controlled trials. Radiother Oncol 106(1):5–14

    PubMed  Google Scholar 

  35. Chow E, Harris K, Fan G et al (2007) Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol 25(11):1423–1436

    PubMed  Google Scholar 

  36. Huisman M, van den Bosch MAAJ, Wijlemans JW et al (2012) Effectiveness of reirradiation for painful bone metastases: a systematic review and meta-analysis. Int J Radiat Oncol Biol Phys 84(1):8–14

    PubMed  Google Scholar 

  37. Chow E, Ling A, Davis L et al (2005) Pain flare following external beam radiotherapy and meaningful change in pain scores in the treatment of bone metastases. Radiother Oncol 75(1):64–69

    PubMed  Google Scholar 

  38. Boehling NS, Grosshans DR, Allen PK et al (2012) Vertebral compression fracture risk after stereotactic body radiotherapy for spinal metastases. J Neurosurg Spine 16(4):379–386

    PubMed  Google Scholar 

  39. Wang XS, Rhines LD, Shiu AS et al (2012) Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1–2 trial. Lancet 13:395–402

    Google Scholar 

  40. Di Staso M, Zugaro L, Gravina GL et al (2011) A feasibility study of percutaneous radiofrequency ablation followed by radiotherapy in the management of painful osteolytic bone metastases. Eur Radiol 21:2004–2010

    PubMed  Google Scholar 

  41. Hirsch AE, Jha RM, Yoo AJ et al (2011) The use of vertebral augmentation and external beam radiation therapy in the multimodal management of malignant vertebral compression fractures. Pain Physician 14:447–458

    PubMed  Google Scholar 

  42. Cazzato RL, Palussière J, Auloge P, Rousseau C, Koch G, Dalili D, Buy X, Garnon J, De Marini P, Gangi A (2020) Complications following percutaneous image-guided radiofrequency ablation of bone tumors: a 10-year dual-center experience. Radiology 296(1):227–235

    PubMed  Google Scholar 

  43. Kotecha R, Schiro BJ, Sporrer J et al (2020) Radiation therapy alone versus radiation therapy plus radiofrequency ablation/vertebral augmentation for spine metastasis: study protocol for a randomized controlled trial. Trials 21:964. https://doi.org/10.1186/s13063-020-04895-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. 2nd Department of Radiology, Medical School, University General Hospital “ATTIKON”, National and Kapodistrian University of Athens, 1 Rimini str, 12462, Athens, Greece

    Dimitrios Filippiadis

  2. 2nd Department of Radiology, Medical School, University General Hospital “ATTIKON”, National and Kapodistrian University of Athens, 1 Rimini str, 12462, Athens, Greece

    Alexis Kelekis

Authors
  1. Dimitrios Filippiadis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexis Kelekis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dimitrios Filippiadis.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethics approval

This is a review paper requiring no IRB approval.

Consent for publication

Consent for publication was obtained for every individual person’s data included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Filippiadis, D., Kelekis, A. Percutaneous bipolar radiofrequency ablation for spine metastatic lesions. Eur J Orthop Surg Traumatol 31, 1603–1610 (2021). https://doi.org/10.1007/s00590-021-02947-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-021-02947-9

Keywords

Search

Navigation