Value of percutaneous radiofrequency ablation with or without percutaneous vertebroplasty for pain relief and functional recovery in painful bone metastases

Skeletal Radiol. 2013 Jan;42(1):25-36. doi: 10.1007/s00256-011-1294-0. Epub 2011 Nov 13.

Abstract

Objective: To evaluate the effectiveness of percutaneous radiofrequency (RF) ablation with or without percutaneous vertebroplasty (PV) on pain relief, functional recovery and local recurrence at 6 months' follow-up (FU), in patients with painful osseous metastases.

Materials and methods: Thirty RF ablations were performed in 24 patients (mean age: 61 years) with bone metastases. Half of the patients had an additional PV. The primary end point was pain relief evaluated by a visual analogue scale (VAS) before treatment, and at 1 and 6 months' FU. Functional outcome was assessed according to the evolution of their ability to walk at 6 months' FU. Imaging FU was available in 20 out of 24 patients with a mean delay of 4.7 months.

Results: Reduction of pain was obtained at 6 months FU in 81% of cases (15 out of 18). Mean pretreatment VAS was 6.4 (±2.7). Mean VAS was 1.9 (±2.4) at 1 month FU, and 2.3 (±2.9) at 6 months' FU. Pain was significantly reduced at 6 months FU (mean VAS reduction = 4.1; P < 0.00001). Functional improvement was obtained in 74% of the cases. Major complications rate was 12.5 % (3 out of 24) with 2 skin burns, and 1 case of myelopathy. Local tumour recurrence or progression was recorded in 5 cases.

Conclusion: Radiofrequency ablation is an effective technique in terms of pain relief and functional recovery for the treatment of bone metastases, which provides a relatively low rate of local recurrence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Bone Neoplasms / secondary*
  • Bone Neoplasms / surgery*
  • Catheter Ablation / methods*
  • Diagnostic Imaging
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain Management
  • Pain Measurement
  • Postoperative Complications
  • Recovery of Function
  • Statistics, Nonparametric
  • Treatment Outcome
  • Vertebroplasty / statistics & numerical data*