Heat distribution in the spinal canal during radiofrequency ablation for vertebral lesions: study in swine

To prospectively evaluate the safety of radiofrequency (RF) ablation for vertebral lesions by monitoring the temperature in swine vertebral models with and without a cortical bone defect.

The institutional animal care and use committee approved the animal studies. In vivo and ex vivo studies were performed. In the in vivo study, 20 lumbar vertebrae from six swine were locally heated by using 1- or 2-cm active-tip internally cooled electrodes. In the ex vivo study, 12 fresh pig cadaver lumbar vertebrae were extracted from four swine, and spinal tumor models with or without cortical bone defect were created by stuffing a cavity with muscle tissue and locally heated by using a 1-cm active-tip internally cooled electrode. The temperature was monitored in the spinal canal and around the vertebral body during ablation. Mann-Whitney U test was used to indicate a significant difference between groups by using 1- and 2-cm active tip in the in vivo study and between groups with and without cortical defect in the ex vivo study.

In the in vivo study in which 1- and 2-cm active-tip needles were used, the temperature in the spinal canal rose to 38.2 degrees C +/- 2.7 (standard deviation) and 45.5 degrees C +/- 6.2, respectively. The latter was significantly higher than the former (P < .001). In the ex vivo study in which tumor models with or without a cortical bone defect were used, the temperature in the spinal canal rose to 48.4 degrees C +/- 6.2 and 31.3 degrees C +/- 3.4, respectively. The former was significantly higher than the latter (P < .001).

For in vivo cases with a 2-cm active tip and ex vivo cases with a vertebral posterior bone defect, the temperature rose to over 45 degrees C, potentially injuring the spinal cord and peripheral nerves.