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Clinical rationale of using steerable technologies for radiofrequency ablation followed by cavity creation and cement augmentation in the treatment of painful spinal metastases

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dc.contributor.author Pusceddu, Claudio
dc.contributor.author Marsico, Salvatore
dc.contributor.author Derudas, Daniele
dc.contributor.author Ballicu, Nicola
dc.contributor.author Melis, Luca
dc.contributor.author Zedda, Stefano
dc.contributor.author De Felice, Carlo
dc.contributor.author Calabrese, Alessandro
dc.contributor.author Santucci, Domiziana
dc.contributor.author Faiella, Eliodoro
dc.date.accessioned 2024-02-29T06:48:38Z
dc.date.available 2024-02-29T06:48:38Z
dc.date.issued 2023
dc.identifier.citation Pusceddu C, Marsico S, Derudas D, Ballicu N, Melis L, Zedda S, De Felice C, Calabrese A, Santucci D, Faiella E. Clinical rationale of using steerable technologies for radiofrequency ablation followed by cavity creation and cement augmentation in the treatment of painful spinal metastases. Curr Oncol. 2023 Apr 19;30(4):4257-68. DOI: 10.3390/curroncol30040324
dc.identifier.issn 1198-0052
dc.identifier.uri http://hdl.handle.net/10230/59293
dc.description.abstract (1) Background: Cement distribution after radiofrequency ablation of spinal metastases can be unpredictable due to various tumor factors, and vertebral augmentation requires advanced devices to prevent cement leakage and achieve satisfactory filling. The purpose of this study is to evaluate the safety and efficacy of a platform of steerable technologies with an articulating radiofrequency ablation (RFA) probe and targeted cavity creation before vertebral augmentation in the treatment of painful spinal metastases. (2) Methods: Sixteen patients (mean age, 67 years) underwent RFA in conjunction with vertebral augmentation after the creation of a targeted balloon cavity for metastatic spinal disease and were followed up to 6 months. Pain and functional mobility were assessed before treatment and postoperatively using the Visual Analogue Score (VAS) and Functional Mobility Scale (FMS). Complications, predictability of cement distribution, anatomical restoration, and local recurrence were collected. Technical success was defined as successful intraoperative ablation and predictable cement distribution after cavity creation without major complications. (3) Results: Sixteen patients with 21 lesions were treated for tumors involving the thoracolumbar spine. All treatments were technically successful and were followed by targeted cavity creation and vertebral augmentation. A statistically significant reduction in median VAS score was observed before treatment and 1 week after RFA treatment (p < 0.001). A total of six of the seven patients who reported limited painful ambulation before treatment reported normal ambulation 1 month after treatment, while the remaining patient reported no improvement. Patients who reported wheelchair use before treatment improved to normal ambulation (four/eight) or limited painful ambulation (four/eight). The improvement in mobility before and after treatment was statistically significant (p = 0.002). Technical success was achieved in all the combined procedures. (4) Conclusions: The combined treatment of RFA and vertebral augmentation with a steerable platform that allows the creation of a targeted cavity prior to cement injection proved to be a safe and effective procedure in our patient sample, resulting in improved quality of life as assessed by the Visual Analogue Score (VAS) and Functional Mobility Scale (FMS).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher MDPI
dc.relation.ispartof Curr Oncol. 2023 Apr 19;30(4):4257-68
dc.rights © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Clinical rationale of using steerable technologies for radiofrequency ablation followed by cavity creation and cement augmentation in the treatment of painful spinal metastases
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3390/curroncol30040324
dc.subject.keyword Quality of life
dc.subject.keyword Radiofrequency ablation
dc.subject.keyword Spinal metastases
dc.subject.keyword Vertebral augmentation
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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