Spinal metastasis and spinal tumors

Spinal metastases are very common in patients with metastatic disease and are one of the most frequent causes of pain and disability in this patient group when the neoplastic process invades the bone and/or causes a fracture. Patients with spinal metastatic disease most often have a short life expectancy, so therapies that are minimally invasive and highly effective are the most preferred treatment strategies. In addition to standard treatments such as chemotherapy and radiation therapy, image-guided thermal ablation therapies can be used to improve the patient's pain and function as well as to increase their survival. Some of the most common radiation therapy treatments for spinal metastases can provide pain relief and local tumor control but can result in suboptimal pain relief and vertebral compression fractures. Radiofrequency ablation and vertebral augmentation are safe and effective techniques to treat spinal metastases and to augment the structural stability of the spine. Other thermal ablative techniques such as cryotherapy or microwave ablation are viable treatment options for tumor ablation that can be used as additional therapies for spinal metastases. The effective application of radiofrequency is most often in combination with vertebral augmentation, and this treatment strategy is supported by numerous studies and prospective trials. The optimal use of radiofrequency ablation and vertebral augmentation involves the appropriate patient identification, tumor characterization, assessment of spinal stability, and the appropriate selection of the treatment modality in order to provide the most optimal treatment outcome in regard to pain relief and functional improvement.