LAUSR

BACKGROUND Approximately 10% of all cancer patients develop spinal metastases. When a symptomatic compression fracture occurs without associated deformity or neurological deficit, it can be treated with kyphoplasty with or without radiofrequency ablation (RFA). Treatment with kyphoplasty is well-established but does not address the underlying oncologic disease. METHODS Retrospective medical chart analysis of breast cancer patients (n=23) with metastatic spinal fractures (n=50 vertebral levels) who underwent RFA and kyphoplasty was undertaken. Key variables of interest included: fracture location, pain levels, and local recurrence. Local recurrence data was compared to published rates of recurrence in breast cancer-related metastatic spinal fractures treated with vertebroplasty or kyphoplasty alone. Data was analyzed using chi-square and t-test statistical analyses. RESULTS The mean preoperative pain level for this cohort was 6.9 on a 10-point VAS scale. Significant reductions in pain levels were observed postoperatively, at discharge (3.5; p < 0.05), at 1-month follow-up (2.8; p < 0.05), at 3-month follow-up (1.1; p < 0.05), and at 6-month follow-up (0.7; p < 0.05). Compared with published data of breast cancer patients with metastatic spinal fractures treated with vertebroplasty or kyphoplasty alone, the addition of RFA resulted in reduced local tumor recurrence (2% vs 14%; p < 0.05). Average length of follow-up was 39 months. CONCLUSION The results suggest that the addition of RFA to kyphoplasty may reduce local tumor recurrence while providing similar pain relief benefits. The extrapolation of this added benefit to metastases from other primary cancers should be examined in future studies.