Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/18243
Title: Combined Vertebral Augmentation and Radiofrequency Ablation in the Management of Spinal Metastases: an Update.
Authors: Kam, Ning Mao;Maingard, Julian;Kok, Hong Kuan;Ranatunga, Dinesh;Brooks, Duncan;Torreggiani, William C;Munk, Peter L;Lee, Michael J;Chandra, Ronil V;Asadi, Hamed
Affiliation: Interventional Radiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
Interventional Neuroradiology Service, Radiology Department, Austin Health, Heidelberg, Victoria, Australia
School of Medicine-Faculty of Health, Deakin University, Waurn Ponds, Geelong, Australia
Department of Interventional Radiology-Guy's and St Thomas' NHS Foundation Trust, London, UK
Interventional Neuroradiology Service-Radiology Department, St Vincent's Hospital, Melbourne, Australia
Department of Radiology, Tallaght Hospital, Dublin, Ireland
Musculoskeletal Division, Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
Interventional Radiology Service-Department of Radiology, Beaumont Hospital, Dublin, Ireland
Interventional Neuroradiology Unit-Monash Imaging, Monash Health, Melbourne, Australia
Department of Imaging, Monash University, Melbourne, Australia
Issue Date: 16-Nov-2017
EDate: 2017
Citation: Current treatment options in oncology 2017; 18(12): 74
Abstract: Spinal metastases are the most commonly encountered tumour of the spine, occurring in up to 40% of patients with cancer. Each year, approximately 5% of cancer patients will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with spinal metastases experience severe and frequently debilitating pain, which often decreases their remaining quality of life. With a median survival of less than 1 year, the goals of treatment in spinal metastases are reducing pain, improving or maintaining level of function and providing mechanical stability. Currently, conventional treatment strategies involve a combination of analgesics, bisphosphonates, radiotherapy and/or relatively extensive surgery. Despite these measures, pain management in patients with spinal metastases is often suboptimal. In the last two decades, minimally invasive percutaneous interventional radiology techniques such as vertebral augmentation and radiofrequency ablation (RFA) have shown progressive success in reducing pain and improving function in many patients with symptomatic spinal metastases. Both vertebral augmentation and RFA are increasingly being recognised as excellent alternative to medical and surgical management in carefully selected patients with spinal metastases, namely those with severe refractory pain limiting daily activities and stable pathological vertebral compression fractures. In addition, for more complicated lesions such as spinal metastasis with soft tissue extension, combined treatments such as vertebral augmentation in conjunction with RFA may be helpful. While combined RFA and vertebral augmentation have theoretical benefits, comparative trials have not been performed to establish superiority of combined therapy. We believe that a multidisciplinary approach as well as careful pre-procedure evaluation and imaging will be necessary for effective and safe management of spinal metastases. RFA and vertebral augmentation should be considered during early stages of the disease so as to maintain the remaining quality of life in this patient population group.
URI: http://ahro.austin.org.au/austinjspui/handle/1/18243
DOI: 10.1007/s11864-017-0516-7
ORCID: 0000-0001-8958-2411
PubMed URL: 29143901
Type: Journal Article
Review
Subjects: Kyphoplasty
Metastasis
Palliative medicine
Radiofrequency Ablation
Spine
Vertebroplasty
Appears in Collections:Journal articles

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