CT-Guided Microwave Ablation with Vertebral Augmentation for Spinal Metastases with Posterior Wall Defects

Xusheng Zhang,1,&ast; Jiacheng Niu,2,&ast; Jing Fan,1 Miaomiao Hu,1 Chao Xing,1 Qianqian Yuan,1 Shen Yang,1 Baohu Wang,1 Peishun Li,1 Qirong Man,1 Yanchen Ren,1 Linlin Wu,1 Kaixian Zhang1 1Department of Oncology, Tengzhou Central People’s Hospital Affiliated to Jining Medical College, Tengzhou, Shandong Province, People’s Republic of China; 2Medical Imaging Center, Tengzhou Central People’s Hospital Affiliated to Jining Medical College, Tengzhou, Shandong Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Kaixian Zhang, Email kaixianzhangtz@163.comPurpose: To evaluate the efficacy and safety of combined microwave ablation (MWA) and vertebral augmentation (VA) in the treatment of spinal metastases with posterior wall defects.Patients and Methods: A retrospective review was conducted for 67 patients (42 men, 25 women) with painful spine metastases and posterior wall defects who underwent MWA combined with VA. Among these patients, 52 vertebrae had no epidural invasion and 33 had mild invasion but did not compress the spinal cord. Procedural effectiveness was determined by comparing visual analog scale (VAS) scores and Oswestry disability index (ODI) scores before the procedure and during the follow-up period.Results: The procedure was technically successful in all patients. The mean VAS score declined significantly from 6.85 ± 1.81 before the procedure to 3.27 ± 1.97 at 24 h, 1.96 ± 1.56 at 1 week, 1.84 ± 1.50 at 4 weeks, 1.73 ± 1.45 at 12 weeks, and 1.71 ± 1.52 at 24 weeks post-procedure (p < 0.01). The mean ODI score was lower post-procedure than before the procedure (p < 0.001). Transient nerve injury occurred in two patients (SIR classification D), and the incidence of asymptomatic bone cement (SIR classification A) was 43.5% (37/85).Conclusion: MWA combined with VA is an effective and safe treatment for painful spine metastases with posterior wall defects.Keywords: microwaves, vertebroplasty, spinal, metastases