• Ahmed Shawky Abdelgawaad, Ali Ezzati, Branko Krajnovic, Sadat Seyed-Emadaldin, and Hamdan Abdelrahman.
• Spine Center, Helios Hospitals Erfurt, Nordhaeuser Street 74, 99089, Erfurt, Germany. ahmed.shawky@aun.edu.eg.
• Eur Spine J. 2021 Oct 1; 30 (10): 2874-2880.

PurposeThis study was designed with an aim to assess the safety and early postoperative outcomes of the combined Radiofrequency ablation (RFA) and Balloon Kyphoplasty (BKP) used for the treatment of painful neoplastic spinal lesions palliatively.Patients And MethodsBetween December 2015 and December 2018, 60 patients (35 men and 25 women) with spinal metastases were operated using RFA and BKP at our institution. Transpedicular biopsy was performed in all cases. Patients' demographics, lesion characteristics, concurrent palliative therapies and complications were recorded. All patients were clinically (Pain score VAS 0-10) and radiologically evaluated pre- and postoperatively. Retrospective analysis of data for this cohort was performed.ResultsSeventy-five painful spinal metastases (46 in the lumbar spine and 29 in the thoracic region) in 60 patients were operated [transpedicular RFA alone in 5 lesions, and in combination with BKP in 70 lesions (93%)]. The mean pre-procedure and post-procedure VAS for back pain was 7.2/10 and 2.7/10, respectively (p value = 0.0001). No neurological complications related to RFA were found and no cement extravasation into the spinal canal was observed. In two patients, asymptomatic leaks into the needle track, in two patients into draining veins and in one patient into the disk space were detected.ConclusionCombined RFA and BKP appears to be a safe, practical, effective and reproducible palliative treatment for painful spinal osteolytic metastasis. In carefully indicated cases, it relieves pain and maintains stability in a minimal invasive way without adding significant surgical trauma or complications.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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