Biomembrane formation after radiofrequency ablation prevents bone cement extravasation during percutaneous vertebroplasty for treating vertebral metastases with posterior margin destruction: An animal study

J Cancer Res Ther. 2020 Sep;16(5):1082-1087. doi: 10.4103/jcrt.JCRT_177_20.

Abstract

Aims: We aimed to investigate the feasibility, safety, and efficacy of radiofrequency ablation (RFA) combined with percutaneous vertebroplasty (PVP) for treating VX2 vertebral metastases with posterior margin destruction in a rabbit model.

Materials and methods: Sixty rabbit models of VX2 vertebral metastases with posterior margin destruction were constructed through computed tomography (CT)-guided percutaneous puncture and randomly divided into four groups of 15 rabbits each: Groups A, RFA+PVP; B, PVP; C, RFA; and D, control. Five rabbits in each group were sacrificed within 24 h of the procedure. Pathological examination and immunohistochemical staining revealed the presence of a biomembrane barrier at the tumor edge; furthermore, bone cement leakage into the spinal canal was observed. The survival time of the remaining rabbits per group was observed, and the differences were analyzed.

Results: CT scans of Group A and C rabbits revealed a low-density band around the tumor ablation region. Bone cement leakage rate significantly differed between Groups A and B (20% vs. 100%; P < 0.05). The average postoperative survival times of Group A, B, C, and D rabbits were 16.72 ± 0.93, 7.26 ± 0.75, 7.80 ± 1.30, and 3.84 ± 1.24 days, respectively, showing a significant difference between Group A and the remaining groups (P < 0.05).

Conclusions: The biomembrane barrier formed at the tumor edge after RFA can prevent bone cement leakage into the spinal canal, reducing spinal cord injury and prolonging the survival time.

Keywords: Biomembrane barrier; VX2; percutaneous vertebroplasty; posterior vertebral margin destruction; radiofrequency ablation.

MeSH terms

  • Animals
  • Biocompatible Materials / chemistry*
  • Combined Modality Therapy
  • Disease Models, Animal
  • Male
  • Membranes / chemistry*
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Postoperative Complications / prevention & control*
  • Rabbits
  • Radiofrequency Ablation / adverse effects*
  • Spinal Cord Injuries / etiology
  • Spinal Cord Injuries / pathology
  • Spinal Cord Injuries / prevention & control*
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / therapy*
  • Survival Rate
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Vertebroplasty / methods*

Substances

  • Biocompatible Materials