Download PDF
Semin intervent Radiol 2019; 36(03): 249-254
DOI: 10.1055/s-0039-1694698
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Interventional Management of Spinal Metastasis

Seon-Kyu Lee
1   Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
,
Brandon Weiss
2   Department of Neurosurgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
,
Vijay Yanamadala
2   Department of Neurosurgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
,
Allan Brook
1   Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
19 August 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Spinal metastasis is usually associated with debilitating pain and results in deteriorating life quality. The role of percutaneous management of spinal metastasis has evolved from a diagnostic role to a significant part of therapeutic options in conjunction with conventional management techniques, including radiotherapy and open surgical options. Percutaneous vertebral augmentation (PVA) showed substantial pain reduction, vertebral stabilization, and improvement of quality of life. Minimally invasive local ablative procedures (MILAPs) demonstrated significant pain reduction, local tumor burden control, and improvement of quality of life. Though combined PVA and MILAP's synergistic role in pain reduction may need additional investigation, considering different actions on spine metastasis patients, combining both techniques might beneficial to selected patients. The role of percutaneous management will likely expand since its role in improving patient's quality of life with very minimal procedure-related risk and in conjunction with future technological advancement.

Keywords

interventional radiology - spine - metastasis - vertebroplasty - kyphoplasty - radiofrequency ablation
 

  • References

  • 1 Bilsky MH, Lis E, Raizer J, Lee H, Boland P. The diagnosis and treatment of metastatic spinal tumor. Oncologist 1999; 4 (06) 459-469
    CrossrefPubMedSearch in Google Scholar
  • 2 Wong DA, Fornasier VL, MacNab I. Spinal metastases: the obvious, the occult, and the impostors. Spine 1990; 15 (01) 1-4
    CrossrefPubMedSearch in Google Scholar
  • 3 Wibmer C, Leithner A, Hofmann G. , et al. Survival analysis of 254 patients after manifestation of spinal metastases: evaluation of seven preoperative scoring systems. Spine 2011; 36 (23) 1977-1986
    CrossrefPubMedSearch in Google Scholar
  • 4 Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin 2009; 59 (04) 225-249
    CrossrefPubMedSearch in Google Scholar
  • 5 Spratt DE, Beeler WH, de Moraes FY. , et al. An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report. Lancet Oncol 2017; 18 (12) e720-e730
    CrossrefPubMedSearch in Google Scholar
  • 6 Jakobs TF, Trumm C, Reiser M, Hoffmann RT. Percutaneous vertebroplasty in tumoral osteolysis. Eur Radiol 2007; 17 (08) 2166-2175
    CrossrefPubMedSearch in Google Scholar
  • 7 Fourney DR, Gokaslan ZL. Spinal instability and deformity due to neoplastic conditions. Neurosurg Focus 2003; 14 (01) e8
    PubMedSearch in Google Scholar
  • 8 Barr JD, Jensen ME, Hirsch JA. , et al; Society of Interventional Radiology; American Association of Neurological Surgeons; Congress of Neurological Surgeons; American College of Radiology; American Society of Neuroradiology; American Society of Spine Radiology; Canadian Interventional Radiology Association; Society of Neurointerventional Surgery. Position statement on percutaneous vertebral augmentation: a consensus statement developed by the Society of Interventional Radiology (SIR), American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), American College of Radiology (ACR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), Canadian Interventional Radiology Association (CIRA), and the Society of NeuroInterventional Surgery (SNIS). J Vasc Interv Radiol 2014; 25 (02) 171-181
    CrossrefPubMedSearch in Google Scholar
  • 9 Sciubba DM, Petteys RJ, Dekutoski MB. , et al. Diagnosis and management of metastatic spine disease. A review. J Neurosurg Spine 2010; 13 (01) 94-108
    CrossrefPubMedSearch in Google Scholar
  • 10 Halpin RJ, Bendok BR, Liu JC. Minimally invasive treatments for spinal metastases: vertebroplasty, kyphoplasty, and radiofrequency ablation. J Support Oncol 2004; 2 (04) 339-351 , discussion 352–355
    PubMedSearch in Google Scholar
  • 11 Klimo Jr P, Schmidt MH. Surgical management of spinal metastases. Oncologist 2004; 9 (02) 188-196
    CrossrefPubMedSearch in Google Scholar
  • 12 de Ruiter GC, Nogarede CO, Wolfs JF, Arts MP. Quality of life after different surgical procedures for the treatment of spinal metastases: results of a single-center prospective case series. Neurosurg Focus 2017; 42 (01) E17
    PubMedSearch in Google Scholar
  • 13 Boriani S, Gasbarrini A, Bandiera S, Ghermandi R, Lador R. En bloc resections in the spine: the experience of 220 patients during 25 years. World Neurosurg 2017; 98: 217-229
    CrossrefPubMedSearch in Google Scholar
  • 14 Klekamp J, Samii H. Surgical results for spinal metastases. Acta Neurochir (Wien) 1998; 140 (09) 957-967
    CrossrefPubMedSearch in Google Scholar
  • 15 Janjan NA. Radiation for bone metastases: conventional techniques and the role of systemic radiopharmaceuticals. Cancer 1997; 80 (8, Suppl): 1628-1645
    CrossrefPubMedSearch in Google Scholar
  • 16 Tong D, Gillick L, Hendrickson FR. The palliation of symptomatic osseous metastases: final results of the Study by the Radiation Therapy Oncology Group. Cancer 1982; 50 (05) 893-899
    CrossrefPubMedSearch in Google Scholar
  • 17 Munk PL, Murphy KJ, Gangi A, Liu DM. Fire and ice: percutaneous ablative therapies and cement injection in management of metastatic disease of the spine. Semin Musculoskelet Radiol 2011; 15 (02) 125-134
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Callstrom MR, Charboneau JW, Goetz MP. , et al. Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiology 2002; 224 (01) 87-97
    CrossrefPubMedSearch in Google Scholar
  • 19 Yang Z, Yang Y, Zhang Y. , et al. Minimal access versus open spinal surgery in treating painful spine metastasis: a systematic review. World J Surg Oncol 2015; 13: 68
    CrossrefPubMedSearch in Google Scholar
  • 20 Georgy BA. Metastatic spinal lesions: state-of-the-art treatment options and future trends. AJNR Am J Neuroradiol 2008; 29 (09) 1605-1611
    CrossrefPubMedSearch in Google Scholar
  • 21 Berenson J, Pflugmacher R, Jarzem P. , et al; Cancer Patient Fracture Evaluation (CAFE) Investigators. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. Lancet Oncol 2011; 12 (03) 225-235
    CrossrefPubMedSearch in Google Scholar
  • 22 Vertebral Augmentation Involving Vertebroplasty or Kyphoplasty for Cancer-Related Vertebral Compression Fractures. A systematic review. Ont Health Technol Assess Ser 2016; 16: 1-202
    PubMedSearch in Google Scholar
  • 23 Chew C, Craig L, Edwards R, Moss J, O'Dwyer PJ. Safety and efficacy of percutaneous vertebroplasty in malignancy: a systematic review. Clin Radiol 2011; 66 (01) 63-72
    CrossrefPubMedSearch in Google Scholar
  • 24 Tian QH, Sun XQ, Lu YY. , et al. Percutaneous vertebroplasty for palliative treatment of painful osteoblastic spinal metastases: a single-center experience. J Vasc Interv Radiol 2016; 27 (09) 1420-1424
    CrossrefPubMedSearch in Google Scholar
  • 25 Chen L, Ni RF, Liu SY. , et al. Percutaneous vertebroplasty as a treatment for painful osteoblastic metastatic spinal lesions. J Vasc Interv Radiol 2011; 22 (04) 525-528
    CrossrefPubMedSearch in Google Scholar
  • 26 Calmels V, Vallée JN, Rose M, Chiras J. Osteoblastic and mixed spinal metastases: evaluation of the analgesic efficacy of percutaneous vertebroplasty. AJNR Am J Neuroradiol 2007; 28 (03) 570-574
    PubMedSearch in Google Scholar
  • 27 Tsoumakidou G, Too CW, Koch G. , et al. CIRSE guidelines on percutaneous vertebral augmentation. Cardiovasc Intervent Radiol 2017; 40 (03) 331-342
    CrossrefPubMedSearch in Google Scholar
  • 28 Barragán-Campos HM, Vallée JN, Lo D. , et al. Percutaneous vertebroplasty for spinal metastases: complications. Radiology 2006; 238 (01) 354-362
    CrossrefPubMedSearch in Google Scholar
  • 29 Vogl TJ, Pflugmacher R, Hierholzer J. , et al. Cement directed kyphoplasty reduces cement leakage as compared with vertebroplasty: results of a controlled, randomized trial. Spine 2013; 38 (20) 1730-1736
    CrossrefPubMedSearch in Google Scholar
  • 30 Fourney DR, Schomer DF, Nader R. , et al. Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg 2003; 98 (1, Suppl): 21-30
    CrossrefPubMedSearch in Google Scholar
  • 31 Schroeder JE, Ecker E, Skelly AC, Kaplan L. Cement augmentation in spinal tumors: a systematic review comparing vertebroplasty and kyphoplasty. Evid Based Spine Care J 2011; 2 (04) 35-43
    Thieme ConnectPubMedSearch in Google Scholar
  • 32 Korovessis P, Repantis T, Miller LE, Block JE. Initial clinical experience with a novel vertebral augmentation system for treatment of symptomatic vertebral compression fractures: a case series of 26 consecutive patients. BMC Musculoskelet Disord 2011; 12: 206
    CrossrefPubMedSearch in Google Scholar
  • 33 Korovessis P, Vardakastanis K, Vitsas V, Syrimpeis V. Is Kiva implant advantageous to balloon kyphoplasty in treating osteolytic metastasis to the spine? Comparison of 2 percutaneous minimal invasive spine techniques: a prospective randomized controlled short-term study. Spine 2014; 39 (04) E231-E239
    CrossrefPubMedSearch in Google Scholar
  • 34 Lane MD, Le HB, Lee S. , et al. Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients. Skeletal Radiol 2011; 40 (01) 25-32
    CrossrefPubMedSearch in Google Scholar
  • 35 Wallace AN, Greenwood TJ, Jennings JW. Use of imaging in the management of metastatic spine disease with percutaneous ablation and vertebral augmentation. AJR Am J Roentgenol 2015; 205 (02) 434-441
    CrossrefPubMedSearch in Google Scholar
  • 36 Wallace AN, Robinson CG, Meyer J. , et al. The metastatic spine disease multidisciplinary working group algorithms. Oncologist 2015; 20 (10) 1205-1215
    CrossrefPubMedSearch in Google Scholar
  • 37 Greenwood TJ, Wallace A, Friedman MV, Hillen TJ, Robinson CG, Jennings JW. Combined ablation and radiation therapy of spinal metastases: a novel multimodality treatment approach. Pain Physician 2015; 18 (06) 573-581
    PubMedSearch in Google Scholar
  • 38 Wallace AN, Tomasian A, Vaswani D, Vyhmeister R, Chang RO, Jennings JW. Radiographic local control of spinal metastases with percutaneous radiofrequency ablation and vertebral augmentation. AJNR Am J Neuroradiol 2016; 37 (04) 759-765
    CrossrefPubMedSearch in Google Scholar
  • 39 Dupuy DE, Hong R, Oliver B, Goldberg SN. Radiofrequency ablation of spinal tumors: temperature distribution in the spinal canal. AJR Am J Roentgenol 2000; 175 (05) 1263-1266
    CrossrefPubMedSearch in Google Scholar
  • 40 Anchala PR, Irving WD, Hillen TJ. , et al. Treatment of metastatic spinal lesions with a navigational bipolar radiofrequency ablation device: a multicenter retrospective study. Pain Physician 2014; 17 (04) 317-327
    PubMedSearch in Google Scholar
  • 41 Goetz MP, Callstrom MR, Charboneau JW. , et al. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol 2004; 22 (02) 300-306
    CrossrefPubMedSearch in Google Scholar
  • 42 Grönemeyer DH, Schirp S, Gevargez A. Image-guided radiofrequency ablation of spinal tumors: preliminary experience with an expandable array electrode. Cancer J 2002; 8 (01) 33-39
    CrossrefPubMedSearch in Google Scholar
  • 43 Fishman B, Pasternak S, Wallenstein SL, Houde RW, Holland JC, Foley KM. The Memorial Pain Assessment Card. A valid instrument for the evaluation of cancer pain. Cancer 1987; 60 (05) 1151-1158
    CrossrefPubMedSearch in Google Scholar
  • 44 Dupuy DE, Liu D, Hartfeil D. , et al. Percutaneous radiofrequency ablation of painful osseous metastases: a multicenter American College of Radiology Imaging Network trial. Cancer 2010; 116 (04) 989-997
    CrossrefPubMedSearch in Google Scholar
  • 45 Clarençon F, Jean B, Pham HP. , et al. Value of percutaneous radiofrequency ablation with or without percutaneous vertebroplasty for pain relief and functional recovery in painful bone metastases. Skeletal Radiol 2013; 42 (01) 25-36
    CrossrefPubMedSearch in Google Scholar
  • 46 Halpin RJ, Bendok BR, Sato KT, Liu JC, Patel JD, Rosen ST. Combination treatment of vertebral metastases using image-guided percutaneous radiofrequency ablation and vertebroplasty: a case report. Surg Neurol 2005; 63 (05) 469-474 , discussion 474–475
    CrossrefPubMedSearch in Google Scholar
  • 47 Tomasian A, Wallace A, Northrup B, Hillen TJ, Jennings JW. Spine cryoablation: pain palliation and local tumor control for vertebral metastases. AJNR Am J Neuroradiol 2016; 37 (01) 189-195
    CrossrefPubMedSearch in Google Scholar
  • 48 Masala S, Roselli M, Manenti G, Mammucari M, Bartolucci DA, Simonetti G. Percutaneous cryoablation and vertebroplasty: a case report. Cardiovasc Intervent Radiol 2008; 31 (03) 669-672
    CrossrefPubMedSearch in Google Scholar
  • 49 Kurup AN, Callstrom MR. Ablation of skeletal metastases: current status. J Vasc Interv Radiol 2010; 21 (8, Suppl): S242-S250
    CrossrefPubMedSearch in Google Scholar
  • 50 Kastler A, Alnassan H, Aubry S, Kastler B. Microwave thermal ablation of spinal metastatic bone tumors. J Vasc Interv Radiol 2014; 25 (09) 1470-1475
    CrossrefPubMedSearch in Google Scholar
  • 51 Kam NM, Maingard J, Kok HK. , et al. Combined vertebral augmentation and radiofrequency ablation in the management of spinal metastases: an update. Curr Treat Options Oncol 2017; 18 (12) 74
    CrossrefPubMedSearch in Google Scholar
  • 52 Reyes M, Georgy M, Brook L. , et al. Multicenter clinical and imaging evaluation of targeted radiofrequency ablation (t-RFA) and cement augmentation of neoplastic vertebral lesions. J Neurointerv Surg 2018; 10 (02) 176-182
    CrossrefPubMedSearch in Google Scholar
  • 53 Hoffmann RT, Jakobs TF, Trumm C, Weber C, Helmberger TK, Reiser MF. Radiofrequency ablation in combination with osteoplasty in the treatment of painful metastatic bone disease. J Vasc Interv Radiol 2008; 19 (03) 419-425
    CrossrefPubMedSearch in Google Scholar
  • 54 Orgera G, Krokidis M, Matteoli M. , et al. Percutaneous vertebroplasty for pain management in patients with multiple myeloma: is radiofrequency ablation necessary?. Cardiovasc Intervent Radiol 2014; 37 (01) 203-210
    CrossrefPubMedSearch in Google Scholar