• Padina S Pezeshki, Sean Davidson, Kieran Murphy, Claire McCann, Elzbieta Slodkowska, Michael Sherar, Albert Jm Yee, and Cari M Whyne.
• University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada.
• Eur Spine J. 2016 Dec 1; 25 (12): 3990-3996.

IntroductionRadiofrequency ablation (RFA) and percutaneous vertebroplasty (PVP) are used independently and in combination to treat metastatically involved vertebrae with the aim of relieving pain, reducing tumour burden and providing bony mechanical stabilization.PurposeThe aim of this work was to characterize the effect of two bone-targeted RFA devices, alone and in combination with PVP, to improve strength and mechanical stability in vertebrae with osteolytic metastatic disease.MethodsSimulated spinal metastases (n = 12) were treated with one of two bone-targeted RFA devices (bipolar cooled or bone coil RF electrodes), followed by PVP. Under axial compressive loading, spinal canal narrowing was measured in the intact specimen, after tumour simulation, post-RFA and post-PVP.ResultsRFA alone resulted in successful tumour shrinkage and cavitation, but further increased canal narrowing under loading. RFA combined with PVP significantly reduced posterior wall stability in samples where sufficient tumour shrinkage and cavitation were coupled with a pattern of cement deposition which extended to posterior vertebral body.ConclusionsRFA combined with cement deposition in the posterior vertebral body demonstrates significantly more stable vertebrae under axial loading.

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