Percutaneous image-guided cryoablation of spinal metastases: A systematic review

Navraj S. Sagoo, Ali S. Haider, Ahmad Ozair, Christopher Vannabouathong, Masum Rahman, Maryam Haider, Neha Sharma, Karuna M. Raj, Sean D. Raj, Justin C. Paul, Michael P. Steinmetz, Owoicho Adogwa, Salah G. Aoun, Peter G. Passias, Shaleen Vira

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.

Original languageEnglish (US)
Pages (from-to)120-126
Number of pages7
JournalJournal of Clinical Neuroscience
Volume96
DOIs
StatePublished - Feb 2022

Keywords

  • Cryoablation
  • Spinal tumor
  • Spine metastases

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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