Artikel
Radiofrequency ablation in patients with spinal metastases
Suche in Medline nach
Autoren
-
Jana Kohl
- Klinik für Neurochirurgie, Universitätsklinikum Magdeburg, Deutschland
-
Boris A. Jöllenbeck
- Klinik für Neurochirurgie, Universitätsklinikum Magdeburg, Deutschland
-
Martin Skalej
- Institut für Neuroradiologie, Universitätsklinikum Magdeburg, Deutschland
-
Raimund Firsching
- Klinik für Neurochirurgie, Universitätsklinikum Magdeburg, Deutschland
| Veröffentlicht: | 16. September 2010 |
|---|
Gliederung
Text
Objective: Radiofrequency ablation (RFA) is an established treatment in patients with hepatic metastases. We used this procedure on patients with spinal metastases and report our experiences of patients treated from 2006 til 2009.
Methods: In a retrospective study we analyzed 27 cases of patients we treated with RFA for spinal metastases between 2006 and 2009. About 50% of patients were between 60 and 70 years old. Four patients were under 60 and four patients were over 80 years old. Twenty patients were men, seven women. Six patients were treated on 2 locations, one patient was treated three times, third time treated on 2 locations.
Results: In three patients kyphoplasty was added in the same session, in four patients kyphoplasty was performed later on. Four further patients needed stabilisation, in case of one patient with soft wire and in case of another patient with replacement of the vertebral body. In cases of 11 patients spinal decompression was needed. 4 patients we operated prior to RFA, in 2 cases RFA was added to decompression in the same operation. In 6 cases decompression was used after RFA. One patient with secondary deterioration was treated conservatively because of poor general status.
Metastases were in 8 cases from nephrocellular carcinoma, in 4 cases from prostatic carcinoma.
18 patients reported about significant improvement of pain after RFA during hospital stay, in two cases neurological deficits improved. In one cases pain remained in parts, but mobilisation improved.
One patient suffered neurological deficits appeared after RFA, which partly improved during postprocedural process. One patient suffered spinal infection with transient deterioration of neurological deficits.
Conclusions: 2 of 3 patients reported a significant reduction of pain. In 11 cases operation for further stabilisation was needed. Summarized, thermoablation in our opinion is an important procedure to reduction of pain and therefore improvement of quality of life as a palliative adjunct to common strategies like operative decompression and stabilisation.
