Microwave ablation combined with cementoplasty under real-time temperature monitoring in the treatment of 82 patients with recurrent spinal metastases after radiotherapy

Baohu Wang, Kaixian Zhang, Xusheng Zhang, Sen Yang, Miaomiao Hu, Peishun Li, Wanying Yang, Jing Fan, Chao Xing, Qianqian Yuan, Baohu Wang, Kaixian Zhang, Xusheng Zhang, Sen Yang, Miaomiao Hu, Peishun Li, Wanying Yang, Jing Fan, Chao Xing, Qianqian Yuan

Abstract

Background: The spine is the most frequently affected part of the skeletal system to metastatic tumors. External radiotherapy is considered the first-line standard of care for these patients with spine metastases. Recurrent spinal metastases after radiotherapy cannot be treated with further radiotherapy within a short period of time, making treatment difficult. We aimed to evaluate the effectiveness and safety of MWA combined with cementoplasty in the treatment of spinal metastases after radiotherapy under real-time temperature monitoring.

Methods: In this retrospective study, 82 patients with 115 spinal metastatic lesions were treated with MWA and cementoplasty under real-time temperature monitoring. Changes in visual analog scale (VAS) scores, daily morphine consumption, and Oswestry Disability Index (ODI) scores were noted. A paired Student's t-test was used to assess these parameters. Complications during the procedure were graded using the CTCAE version 5.0.

Results: Technical success was attained in all patients. The mean VAS score was 6.3 ± 2.0 (range, 4-10) before operation, and remarkable decline was noted in one month (1.7 ± 1.0 [P < .001]), three months (1.4 ± 0.8 [P < .001]), and six months (1.3 ± 0.8 [P < .001]) after the operation. Significant reductions in daily morphine consumption and ODI scores were also observed (P < .05). Cement leakage was found in 27.8% (32/115) of lesions, with no obvious associated symptoms.

Conclusion: MWA combined with cementoplasty under real-time temperature monitoring is an effective and safe method for recurrent spinal metastases after radiotherapy.

Keywords: Cementoplasty; Microwave ablation; Real-time temperature monitoring; Recurrent spinal metastases.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
A 58-year-old man with lung adenocarcinoma with L2 osteolytic metastasis (recurrence after radiotherapy) treated with MWA in combination with cementoplasty. L2 osteolytic metastasis showed on axial and sagittal reconstructed CT (a, b). The microwave ablation antennas (arrowheads) were inserted into the lesion through bilateral access (c, d). The thermometric electrode (arrow) was inserted into the left intervertebral foramen (e). The cement deposited in the vertebral body without significant leakage on axial and sagittal CT (f, g)
Fig. 2
Fig. 2
The changes of visual analog scale (VAS) scores (A), Daily morphine dose (mg) (B), and Oswestry Disability Index (ODI) (C) after operation

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