Palliative Ablation and Kyphoplasty for a Suspected Metastatic Fracture

Hanna Thompson discusses her CIO2023 abstract, "CIO 2023-30 Palliative Ablation and Kyphoplasty for a Suspected Metastatic Fracture."

Palliative Ablation and Kyphoplasty for a Suspected Metastatic Fracture from HMP on Vimeo.

My name is Hannah Thompson. I'm a 4th year medical student at the University of Louisville and I'm here today to talk about my poster palliative ablation and kyphoplasty for a suspected metastatic fracture. So in this case, we describe a successful radiofrequency ablation and balloon kyphoplasty, See a very painful lytic lesion, at the L4 vertebral body in a patient who had metastatic renal cell carcinoma. This patient had a 2 year history of stage 4 renal cell carcinoma and was experiencing persistent, very severe Lower back pain attributable to a metastatic fracture of the L4 vertebra. She chose to do RFA and kyphoplasty as opposed to stereotactic radiosurgery, for treatment of this lesion.

So the a biopsy was first obtained in the procedure. Then a MERIT Stability first fracture kit, was used. An osteotome was inserted into, the vertebra Through a transpedicular approach bilaterally, the ablation was then carried out through an ablation probe, And then a balloon and cement were, injected as part of the kyphoplasty procedure. The procedure was technically successful, and the patient experienced relief of her back pain. The biopsy specimen was negative, but we believe that that was secondary to inadequate sampling.

Metastatic bone lesions often result in severe pain, most frequently involving the lumbar spine. And the stereotactic radiosurgery has traditionally been used as the first line treatment. However, it's associated with a higher risk of fracture of the adjacent vertebra, whereas RFA with subsequent balloon kyphoplasty,