Combination treatment of vertebral metastases using image-guided percutaneous radiofrequency ablation and vertebroplasty: a case report

We describe a case of vertebral metastases treated with a combination of percutaneous radiofrequency ablation (RFA) and vertebroplasty in a single session.

A 45-year-old female with recently diagnosed metastatic non-small cell lung cancer was referred for consideration of vertebroplasty after having several weeks of back pain. Computed tomography and magnetic resonance imaging scans of the thoracic spine revealed metastatic lesions at the T9 and T12 bodies. Radiofrequency ablation was performed using a starburst array electrode (Rita Medical Systems, Mountain View, Calif). The metastatic lesion in the T9 vertebral body measured 1.5 x 1.5 cm and was heated to 100 degrees C for 5 minutes. Vertebroplasty was then performed on this lesion as well as a lesion at T12 with no complications. The patient was discharged home the same day without complaints.

Radiofrequency ablation and vertebroplasty are minimally invasive procedures that can be used in combination to treat spinal metastases. The pain relief from these treatments is often immediate. RFA can also be used to minimize procedure-related complications during the vertebroplasty. In properly selected patients, RFA may also increase the duration of local spinal stabilization afforded by the vertebroplasty alone. Long-term studies are warranted to assess the efficacy and durability of this unique approach.