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Radiofrequency-Targeted Vertebral Augmentation for the Treatment of Vertebral Compression Fractures as a Result of Multiple Myeloma

Erdem, Eren, MD*; Akdol, Sertac, MD; Amole, Adewumi, MD*; Fryar, Katy, RN; Eberle, Robert W.

doi: 10.1097/BRS.0b013e3182959695
Clinical Case Series

Study Design. A retrospective review of a consecutive population of patients treated with radiofrequency-targeted vertebral augmentation (RF-TVA) for malignant vertebral compression fractures (VCFs).

Objective. To investigate the safety and efficacy of RF-TVA in patients with malignant VCFs.

Summary of Background Data. The use of polymethylmethacrylate (PMMA) in vertebroplasty and balloon kyphoplasty for patients with recalcitrant pain after acute VCFs is shown to be safe, successful in stabilizing the VCF, and effective for the relief of pain after osteoporotic and malignant VCFs. RF-TVA using targeted cavity creation and ultrahigh viscosity PMMA delivery with a long handling time was developed to address the potential adverse issues that arise with vertebroplasty and balloon kyphoplasty.

Methods. Between December 2008 and May 2009, a consecutive series of 66 RF-TVA procedures were performed by the authors for VCF secondary to multiple myeloma. Pre- and postoperatively, a standard 10-point visual analogue scale was used to assess back pain. Pain medication use and activity categories were defined and monitored for changes before and after RF-TVA. All patients were followed for 6 months postoperatively.

Results. At 6 months postoperatively, significant improvement in pain, activity, and narcotic use was observed. There were no pulmonary or neurological complications, and one patient had radiographical evidence of asymptomatic leakage of PMMA into the vertebral disc space.

Conclusion. We report optimum safety and efficacy results in the treatment of malignant VCFs with a novel RF-TVA technique in which controlled delivery of an ultrahigh viscosity PMMA is used for fracture stabilization. The deposition of PMMA with RF-TVA is predictable and uniform, and can be performed without the PMMA handling constraints that may be encountered with vertebroplasty and balloon kyphoplasty. The safety and efficacy we report with RF-TVA achieved equivalency with other methods of treatment for VCF stabilization.

We report optimum safety and efficacy in the treatment of malignant vertebral compression fractures using a novel radiofrequency-targeted vertebral augmentation (RF-TVA) technique with controlled delivery of ultrahigh viscous-polymethylmethacrylate (PMMA) for fracture stabilization. The deposition of PMMA with RF-TVA is predictable, uniform, and can be performed without PMMA handling constraints that may be encountered with vertebroplasty and balloon kyphoplasty.

*Department of Radiology, and

Interventional Neuroradiology, The University of Arkansas for Medical Sciences, Little Rock, AR; and

Clinical Information Consultants, Apex, NC.

Address correspondence and reprint requests to Eren Erdem, MD, Departments of Radiology and Neurosurgery, and Interventional Neuroradiology, Division of Neuroradiology, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR 72205; E-mail: erenmri@yahoo.com

Acknowledgment date: October 28, 2011. Revision date: July 5, 2012. Acceptance date: January 4, 2013.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work.

One or more of the author(s) has/have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript: e.g., honoraria, gifts, consultancies, royalties, stocks, stock options, decision making position.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins