Faculty, Staff and Student Publications
Publication Date
5-1-2025
Journal
Radiology: Imaging Cancer
DOI
10.1148/rycan.240122
PMID
40377420
PMCID
PMC12130721
PubMedCentral® Posted Date
5-16-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Purpose: To evaluate the safety and efficacy of vertebral augmentation (VA) and radiofrequency ablation (RFA) for treating pathologic spinal fractures in patients with cancer and adjacent fracture risk following treatment.
Materials and Methods: This single-institution retrospective study, conducted from January 2017 to September 2020, included patients with cancer who underwent percutaneous VA with or without spine RFA for pathologic spine compression fractures. The primary outcome was pain reduction, assessed using the 10-point visual analog scale before the procedure, at first follow-up, and 2–4 weeks after the procedure. Logistic regression was performed to identify factors associated with epidural cement leak.
Results: A total of 638 spinal levels in 335 patients (median age, 65 years [IQR, 58–74 years]; 147 female, 188 male) were treated. Epidural tumor and retropulsion of bone fragments were present in 15% (93 of 638) and 13% (81 of 638) of treated levels, respectively, while posterior wall erosion was observed in 30% (190 of 638). Substantial pain improvement (greater than two-point reduction) occurred in 81% (519 of 638) of cases. Factors associated with decreased risk of epidural cement leak included RFA (42% no leak vs 38% leak, P = .03) and lumbar treatments (49% no leak vs 38% leak, P = .02). Adjacent-level fractures occurred in 10.4% of patients. The total complication rate (National Cancer Institute Common Terminology Criteria for Adverse Events grade 3 or higher) was 0.6% (four of 638).
Conclusion: VA and RFA are safe and efficacious treatments for spine fractures in patients with cancer.
Keywords
Humans, Female, Male, Middle Aged, Retrospective Studies, Aged, Spinal Neoplasms, Spinal Fractures, Radiofrequency Ablation, Fractures, Compression, Vertebroplasty, Treatment Outcome, Pain Measurement, Ablation Techniques, Kyphoplasty, Vertebroplasty
Published Open-Access
yes
Recommended Citation
Stringam, Jeremiah; Pal, Koustav; Niekamp, Andrew; et al., "Safety, Efficacy, and Adjacent-level Fracture Risk Following Vertebral Augmentation and Radiofrequency Ablation for the Treatment of Spine Metastases in Patients with Cancer" (2025). Faculty, Staff and Student Publications. 4939.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4939
Graphical Abstract
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