J Bone Oncol 2018 Sep 20;12:69-77. Epub 2018 Jul 20.
Department of Medical Imaging, The First Affiliated Hospital, Kunming Medical University, 295 Xichang Road, Kunming 650032, Yunnan, PR China.
Purpose: To investigate effects and heat distribution of radiofrequency ablation (RFA) on vertebral tumors in vitro and in vivo swine experiments and its clinical application.
Materials And Methods: RFA was performed on the swine spine in vitro and in vivo for 20 min at 90 °C at the electrode tip, and the temperature at the electrode tip and surrounding tissues were recorded. Clinical application of ablation combined with vertebroplasty was subsequently performed in 4 patients with spinal tumors.
Results: In the in vitro study, the mean temperature at the front and ventral wall of the spinal canal was 50.8 °C and 43.6 °C, respectively, at 20 mm significantly greater than 37.7 °C and 33.7 ± 1.7 °C, respectively, at 10 mm ablation depth. The coagulative necrosis area was significantly ( < 0.0001) greater at 20 mm depth than at 10 mm depth (mean 17.0 × 20.7 mm vs. 14.2 × 16.6 mm). In the in vivo experiment, the local temperature increased significantly ( < 0.05) from around 36 °C before ablation to over 41 °C at 20 min after ablation, with the temperature at the electrode tip (90.4 °C) and within the vertebral body (67.0 °C) significantly ( < 0.05) greater than at the posterior (41.9 °C) and lateral wall (41.8 °C). From 2 to 5 weeks, bone remodeling began. Clinically, all four patients had successful RFA and vertebroplasty, with no neurological deficits. The pain scores were significanlty ( < 0.05) improved before (4.5-10, mean 8.0) compared with at four weeks (0-1.8, mean 1.8).
Conclusion: The clustered electrode can be efficiently and safely applied in the treatment of spinal tumors without damaging the spinal cord and adjacent nerves by heat distribution.
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