E-ISSN 1305-3612
Interventional Radiology - Original Article
CT fluoroscopy-guided percutaneous osteoplasty with or without radiofrequency ablation in the treatment of painful extraspinal and spinal bone metastases: technical outcome and complications in 29 patients
1 Institute for Clinical Radiology, University Hospitals Munich – Campus Großhadern, München Germany  
Diagn Interv Radiol ; : -



Purpose: To assess the safety and technical outcome of CT (Computed Tomography) fluoroscopy-guided osteoplasty with or without prior percutaneous radiofrequency ablation (RFA) in patients with painful osteolyses.


Methods: A retrospective analysis of 29 individual patients (16 women, 13 men; 63.1±14.4 [MV±SD] years) was performed undergoing CT fluoroscopy (10-20 mAs tube current) - guided osteoplasty with (n=26) or without (n=14) RFA of painful extraspinal and spinal osteolyses treated in 33 consecutive procedures from 2002 to 2016. Technical success in terms of at least one complete RFA cycle and subsequent polymethyl metacrylate (PMMA) bone cement injection (cement deposit covering ≥75% of longest diameter of extraspinal osteolysis [axial plane] or of distance between vertebral endplates), intra-/postinterventional procedure-related complications (30 day period) and dose-length-product (DLP) were evaluated.


Results: 40 osteolyses were located in the pelvis (acetabulum, 10; iliac bone, 4), spine (thoracic, 6; lumbar, 5; sacral, 8), long bones (femur, 3; tibia, 1), sternum (2) and glenoid (1). Mean (±SD) size of the treated osteolysis was 4.0±1.2cm (range, 1.9-6.9cm). 31/40 (77.5%) osteolyses abutted neighbouring risk structures (spinal canal or neuroforamen, 18; neighbouring joint, 11; other, 8). Mean (±SD) number of RFA electrode positions and complete ablation cycles was 1.5±0.9 and 2.1±1.7, respectively. Mean (±SD) PMMA filling volume was 7.7±5.7mL (range, 2-30mL). Small asymptomatic PMMA leakages were observed in 15/40 lesions (37.5%). Mean (±SD) total DLP was 850±653 mGy*cm. Six minor complications without any major complications were observed.


Conclusion: CT fluoroscopy-guided percutaneous osteoplasty with or without concomitant RFA for the treatment of painful extraspinal and spinal osteolyses can be performed with a low complication rate and high technical success.

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