Abstract
BackgroundTo investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases.MethodsThe medical records of patients with spinal metastatic tumor admitted to our hospital from January 2016 to December 2018 were retrospectively analyzed. Based on different surgical methods, the patients were divided into groups A (treated with RFA combined with bone cement) and B (treated with bone cement only). Group A included 35 patients with 47 segments of diseased vertebral bodies. Group B consisted of 52 patients with 78 vertebral segments. Pain, quality of life score, vertebra height, bone cement leakage, postoperative tumor recurrence, and complications were assessed 3 days and 1 and 6 months after surgery.ResultsAll the patients had smooth operation without paraplegia, spinal cord injury, and perioperative death. Visual analogue scales (VAS) and Oswestry Disability Index (ODI) scores of the two groups significantly improved 3 days and 1 month after surgery compared with those before surgery (P < 0.05), but no significant difference was observed between the two groups (P > 0.05). Six months after surgery, the VAS and ODI scores of patients in group A were lower than those in group B, with statistically significant differences (P < 0.05). The postoperative vertebral body height of the two groups significantly increased compared with that before surgery, and the difference was statistically significant (P < 0.05). Meanwhile, no significant difference was observed between the two groups (P > 0.05). Postoperative bone cement permeability in group A was 6.4%, and postoperative tumor recurrence rate was 11.4%. The permeability of bone cement in group B was 20.5%, and the tumor recurrence rate was 30.8%. The bone cement permeability and tumor recurrence rate in group A were lower than those in group B, with statistically significant differences (P < 0.05).ConclusionsBone cement combined with RFA for the treatment of spinal metastases can achieve good efficacy, desirable analgesic effect, low incidence of complications, small surgical trauma, and high safety. The proposed method has the value of clinical popularization and application.
Highlights
To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases
This study investigated the clinical efficacy and safety of RFA combined with Percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) in the treatment of patients with spinal metastatic tumor
The pain score of the bone cement combined with RFA group was lower than that of the bone cement only group, with a statistically significant difference (P < 0.05) (Table 2)
Summary
To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases. About 50% of metastatic bone cancers occur in the spine [1]. Osteolytic destruction most commonly occurs in patients with metastatic spinal cancer. Pathological fracture of the spine is caused by tumor invasion of the vertebral body and its appendages, resulting in severe pain in the lower back, spinal dysfunction, neurological dysfunction, and paraplegia, seriously affecting the quality of life [2]. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are commonly used in patients with vertebral metastatic carcinoma to enhance the strength of the vertebral body with bone cement injection, relieve the patients’ pain, and improve the patients’ quality of life, defects, such as bone cement leakage and poor tumor control, occur [4, 5]. RFA can cause cavity formation in the vertebra, reduce the stability of the posterior wall of the vertebra, and increase the fracture risk [6]
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