Radiofrequency Ablation of Spine Metastases: A Clinical and Technical Approach.

Percutaneous radiofrequency ablation (RFA) is an integral component of the multidisciplinary treatment algorithm for both local tumor control and palliation of painful spine metastases. This minimally invasive therapy complements additional treatment strategies, such as pain medications, systemic chemotherapy, surgical resection, and radiotherapy. The location and size of the metastatic lesion dictate preprocedure planning and the technical approach. For example, ablation of lesions along the spinal canal, within the posterior vertebral elements, or with paraspinal soft tissue extension are associated with a higher risk of injury to adjacent spinal nerves. Additional interventions may be indicated in conjunction with RFA. For example, ablation of vertebral body lesions can precipitate new, or exacerbate existing, pathologic vertebral compression fractures that can be prevented with vertebral augmentation. This article reviews the indications, clinical work-up, and technical approach for RFA of spine metastases.

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Stephen Chen reports grants or contracts from Adopt a Scientist Foundation and consulting fees from Boston Scientific Corporation for the Glioblastoma Advisory Board and Balt USA for the Peripheral Embolic Advisory Board.Rahul A. Sheth reports consulting fees from Medtronic.Steven Yevich reports consulting fees from Medtronic (not related to this article) and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Medtronic and Varian-Endocare.