Value of radiofrequency ablation combined with percutaneous vertebroplasty in the treatment of metastatic spinal tumor / 中国医师进修杂志

ABSTRACT

Objective To evaluate the value of radiofrequency ablation (RFA) combined with percutaneous vertebroplasty (PVP) in the treatment of metastatic spinal tumor. Methods The clinical data of 94 hospitalized patients with metastatic spinal tumor from January 2013 to January 2017 were retrospectively analyzed.The patients were divided into PVP group(43 cases)and RFA+PVP(51 cases) according to the different treatment methods. The visual analogue scores (VAS) before operation and 1 month after operation were observed.The serum levels of N-telopeptide of typeⅠcollagen(NTx),carboxy terminal telopeptide typeⅠcollagen(ICTP)and bone alkaline phosphatase(BAP)before operation and 1 month after operation were monitored.The recurrence rate of tumor 6 months after operation was record. Results The VAS before operation in PVP group was (7.67 ± 1.12) scores, in RFA + PVP group was (7.71 ± 1.04) scores, and there was no statistical difference (P>0.05). The VAS of 2 groups after operation was significantly lower than that before operationPVP group(3.17 ± 0.26)scores,RFA+PVP group (2.66 ± 0.31) scores, and there were statistical differences (P<0.05). The VAS in RFA + PVP group was significantly lower than that in PVP group(P<0.05).The serum levels of NTx,ICTP and BAP before operation in PVP group were(25.39 ± 9.77)nmol/L,(36.71 ± 8.77)μg/L,(73.66 ± 14.60)μg/L;after operation were (19.34 ± 6.32) nmol/L, (21.14 ± 6.66) μg/L, (33.63 ± 7.50) μg/L, and there were statistical differences before and after operation (P<0.05). The serum levels of NTx, ICTP and BAP before operation in RFA+PVP group were(26.63 ± 10.53)nmol/L,(35.37 ± 9.42)μg/L,(75.24 ± 13.01) μg/L; those after operation were (12.10 ± 5.17) nmol/L, (15.14 ± 5.08) μg/L, (27.19 ± 8.22) μg/L, and there were statistical differences before and after operation(P<0.05).The serum levels of NTx,ICTP and BAP after operation in RFA + PVP group were significantly lower than those in PVP group (P < 0.05). The recurrence rate of tumor 6 months after operation in RFA+PVP group was significantly lower than that in PVP group 3.92% (2/51) vs. 16.28% (7/43), and there was statistical difference (P<0.05). Conclusions Compared with simple PVP, RFA combined with PVP can reduce the pain symptoms, reduce the recurrence rate and improve the quality of life in patients with metastatic spinal tumor.