Computed tomography-guided microwave ablation combined with percutaneous vertebroplasty for treatment of painful high thoracic vertebral metastases

Abstract

Purpose To retrospectively evaluate the efficacy and safety of computed tomography (CT)-guided microwave ablation (MWA) combined with percutaneous vertebroplasty (PVP) as a treatment for painful high thoracic vertebral metastases (T1–T4). Materials and Methods In this retrospective study, 23 adult patients (33 high thoracic vertebral metastases) with moderate to severe pain were treated with CT-guided MWA and PVP. The procedural effectiveness was evaluated using a Visual Analog Scale (VAS), daily morphine consumption, and the Oswestry Disability Index (ODI) before and immediately after the procedure and during follow-up. Results Technical success was achieved in all patients. The mean pre-procedure VAS score and morphine doses were 6.7 ± 1.7 (5–10) and 105.2 ± 32.7 (30–150) mg, respectively. The mean VAS scores and daily morphine doses at 24 h and 1, 4, 12, and 24 weeks post-operatively were 3.2 ± 1.4 and 41.3 ± 9.6 mg; 1.8 ± 1.0 and 31.5 ± 12.2 mg; 1.4 ± 1.3 and 19.6 ± 12.4 mg; 1.1 ± 0.8 and 14.5 ± 9.6 mg; and 1.0 ± 0.7 and 13.9 ± 9.3 mg, respectively (all p < 0.001). ODI scores significantly decreased (p < 0.05). Minor cement leakage occurred in 10 patients (30.30%) with no symptoms. Follow-up imaging showed no local tumor progression. Conclusions Preliminary results suggest MWA combined with PVP is an effective and safe treatment for painful high thoracic vertebral metastases (T1–T4) and can significantly relieve pain and improve the quality of life of patients. However, its efficacy should be confirmed by mid- and long-term studies.

Keywords

• computed tomography
• microwave ablation
• percutaneous vertebroplasty
• thoracic vertebrae
• visual analog scale