Longitudinal Radiographical Changes Following Minimally Invasive Ablation and Cementoplasty of Osteolytic Vertebral Metastases: A Retrospective Study.

IF 1.6 4区 医学 Q3 ORTHOPEDICS
Will Jiang, Sangmin Lee, Donghao Gan, Igor Latich
{"title":"Longitudinal Radiographical Changes Following Minimally Invasive Ablation and Cementoplasty of Osteolytic Vertebral Metastases: A Retrospective Study.","authors":"Will Jiang, Sangmin Lee, Donghao Gan, Igor Latich","doi":"10.1177/15563316251346485","DOIUrl":null,"url":null,"abstract":"<p><p><i>Background:</i> For orthopedic oncology patients who are poor candidates for open spine surgery, minimally invasive radiofrequency ablation and cementoplasty (RFA/C) is becoming increasingly popular for managing osteolytic vertebral metastases. <i>Purpose:</i> We sought to characterize long-term changes in vertebral body radiographical parameters and potential risk of adjacent fractures occurring. <i>Methods:</i> A single-institution, retrospective study of all patients receiving RFA/C for osteolytic thoracic or lumbar vertebral body metastases from 2017 to 2023 was conducted. Vertebral body integrity was assessed by column height changes (anterior, middle, and posterior 1/3), local vertebral angle, and indirect bone mass assessment (at 3, 6, 12, and 24 months postoperatively). The latter was assessed via Hounsfield unit (HU) changes on axial computed tomography. Adjacent vertebral fractures were defined as within 3 vertebral levels above or below index site. Treatment history including radiation therapy was tracked. <i>Results:</i> A total of 54 vertebral levels (26 patients; mean age 59.8 ± 19.0 years; 18 females) were included (mean follow-up 15.8 ± 13.8 months). HU (bone mass proxy) stabilized after RFA/C. Except for middle column height increasing at 3 months, no column height or local angle deformity changes were detected. Adjacent fracture occurred in 4 patients (15.4%); all 4 demonstrated systemic cancer progression. <i>Conclusions:</i> Our findings suggest that RFA/C may provide effective long-term stabilization of the index site that is maintained for at least 1 year postoperatively. All patients who experienced an adjacent fracture occurrence demonstrated radiographic evidence of cancer progression surrounding the treatment sites that appeared unrelated to the procedure itself.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316251346485"},"PeriodicalIF":1.6000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204986/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hss Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15563316251346485","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: For orthopedic oncology patients who are poor candidates for open spine surgery, minimally invasive radiofrequency ablation and cementoplasty (RFA/C) is becoming increasingly popular for managing osteolytic vertebral metastases. Purpose: We sought to characterize long-term changes in vertebral body radiographical parameters and potential risk of adjacent fractures occurring. Methods: A single-institution, retrospective study of all patients receiving RFA/C for osteolytic thoracic or lumbar vertebral body metastases from 2017 to 2023 was conducted. Vertebral body integrity was assessed by column height changes (anterior, middle, and posterior 1/3), local vertebral angle, and indirect bone mass assessment (at 3, 6, 12, and 24 months postoperatively). The latter was assessed via Hounsfield unit (HU) changes on axial computed tomography. Adjacent vertebral fractures were defined as within 3 vertebral levels above or below index site. Treatment history including radiation therapy was tracked. Results: A total of 54 vertebral levels (26 patients; mean age 59.8 ± 19.0 years; 18 females) were included (mean follow-up 15.8 ± 13.8 months). HU (bone mass proxy) stabilized after RFA/C. Except for middle column height increasing at 3 months, no column height or local angle deformity changes were detected. Adjacent fracture occurred in 4 patients (15.4%); all 4 demonstrated systemic cancer progression. Conclusions: Our findings suggest that RFA/C may provide effective long-term stabilization of the index site that is maintained for at least 1 year postoperatively. All patients who experienced an adjacent fracture occurrence demonstrated radiographic evidence of cancer progression surrounding the treatment sites that appeared unrelated to the procedure itself.

骨溶解性椎体转移瘤微创消融和骨水泥成形术后的纵向影像学变化:回顾性研究。
背景:对于不适合开放脊柱手术的骨科肿瘤患者,微创射频消融和骨水泥成形术(RFA/C)在治疗溶骨性椎体转移中越来越受欢迎。目的:我们试图描述椎体影像学参数的长期变化和相邻骨折发生的潜在风险。方法:对2017年至2023年接受RFA/C治疗溶骨性胸椎或腰椎椎体转移的所有患者进行单机构回顾性研究。通过柱高度变化(前、中、后1/3)、局部椎体角度和间接骨量评估(术后3、6、12、24个月)评估椎体完整性。后者通过轴向计算机断层扫描的Hounsfield单位(HU)变化进行评估。相邻椎体骨折定义为指数点以上或以下3个椎体节段内。追踪治疗史,包括放射治疗。结果:共54个椎体节段(26例;平均年龄59.8±19.0岁;女性18例),平均随访15.8±13.8个月。RFA/C后HU(骨量代理)稳定。除3个月时柱中高度增高外,未见柱高及局部角度畸形改变。相邻骨折4例(15.4%);4例患者均表现出全身性癌症进展。结论:我们的研究结果表明RFA/C可以提供有效的指数部位长期稳定,并在术后至少维持1年。所有发生相邻骨折的患者都有放射学证据表明,治疗部位周围的癌症进展似乎与手术本身无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Hss Journal
Hss Journal Medicine-Surgery
CiteScore
3.90
自引率
0.00%
发文量
42
期刊介绍: The HSS Journal is the Musculoskeletal Journal of Hospital for Special Surgery. The aim of the HSS Journal is to promote cutting edge research, clinical pathways, and state-of-the-art techniques that inform and facilitate the continuing education of the orthopaedic and musculoskeletal communities. HSS Journal publishes articles that offer contributions to the advancement of the knowledge of musculoskeletal diseases and encourages submission of manuscripts from all musculoskeletal disciplines.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信