Longitudinal Radiographical Changes Following Minimally Invasive Ablation and Cementoplasty of Osteolytic Vertebral...

Area of Science:

• Orthopedic Oncology
• Interventional Radiology
• Spine Surgery

Background:

• Minimally invasive radiofrequency ablation and cementoplasty (RFA/C) is an emerging treatment for osteolytic vertebral metastases in patients unsuitable for open surgery.
• This study evaluates the long-term efficacy and safety of RFA/C in managing vertebral metastases.

Purpose of the Study:

• To assess long-term radiographic changes in vertebral bodies treated with RFA/C.
• To investigate the incidence and potential risk factors for adjacent vertebral fractures post-RFA/C.

Main Methods:

• Retrospective analysis of 54 vertebral levels in 26 patients treated with RFA/C for osteolytic metastases (2017-2023).
• Radiographical assessment included vertebral body height, local angle, and Hounsfield units (HU) at 3, 6, 12, and 24 months.
• Adjacent fractures were defined as occurring within 3 vertebral levels of the index site.

Main Results:

• Vertebral body bone mass (HU) stabilized post-RFA/C, with no significant long-term changes in column height or local angle.
• Adjacent fractures occurred in 15.4% of patients, all of whom had evidence of systemic cancer progression.
• The observed adjacent fractures were deemed unrelated to the RFA/C procedure.

Conclusions:

• RFA/C provides effective and durable stabilization of the treated vertebral site for at least one year.
• Adjacent fractures following RFA/C are associated with underlying cancer progression rather than procedural complications.