Comparison of the postoperative pain change and spinal stenosis rate between percutaneous vertebroplasty combined with radiofrequency ablation and with 125I particle implantation in the treatment of metastatic spinal cord compression: A retrospective study

Yu He; Shilong Han; Chungen Wu; Fei Ge; Jianbo Wang

doi:10.1016/j.jimed.2021.10.002

Comparison of the postoperative pain change and spinal stenosis rate between percutaneous vertebroplasty combined with radiofrequency ablation and with ¹²⁵I particle implantation in the treatment of metastatic spinal cord compression: A retrospective study

J Interv Med. 2021 Dec 23;4(4):197-202. doi: 10.1016/j.jimed.2021.10.002. eCollection 2021 Nov.

Authors

Yu He¹, Shilong Han², Chungen Wu¹, Fei Ge³, Jianbo Wang¹

Affiliations

¹ Department of Interventional Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
² Department of Intervention and Vascular Surgery, Shanghai Tenth People's Hospital Affiliated to Shanghai Tongji University School of Medicine, Shanghai, China.
³ Medical Department, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.

Abstract

Background context: Metastatic spinal cord compression (MSCC) seriously affects the survival rate.

Objective: The therapeutic effects of two treatment strategies for MSCC: percutaneous vertebroplasty (PVP) combined with radiofrequency ablation (RFA) and PVP combined with ¹²⁵I particle implantation, were compared.

Study design: Retrospective study.

Patient sample: 40 patients with MSCC were divided into two groups: 19 cases in the RFA group and 21 cases in the ¹²⁵I group.

Method: All patients were accessed to determine the differences in pain, which was evaluated using the visual analog scale (VAS) at 1 week, 1 month, and 3 months after the operation, and spinal stenosis rates (SSRs), which were measured at 1 and 3 months after the operation, between the two groups.

Results: The VAS scores and SSRs at baseline were comparable between the RFA group and the ¹²⁵I group (7.19 ± 2.07 vs 7.42 ± 1.95, 37.7% ± 11.2% vs 41.1% ± 11.4%). The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups, compared with those at baseline. The VAS scores and SSRs in the ¹²⁵I group were lower than those in the RFA group at 3 months after the operation (1.09 ± 0.97 vs 1.75 ± 1.06 p = 0.048 and 12.3% ± 6.4% vs 18.1% ± 10.1% p = 0.034), while the VAS scores at 1 week after the operation in the RFA group were lower than those in the ¹²⁵I group (4.39 ± 1.34 vs 5.05 ± 1.82 p = 0.049).

Conclusion: PVP combined with RFA has a slight advantage in relieving pain in the short term, while PVP combined with ¹²⁵I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.

Keywords: 125I particle; Metastatic spinal cord compression; Pain management; Radiofrequency ablation; Vertebroplasty.