Radiofrequency ablation as an adjunct to balloon kyphoplasty or percutaneous vertebroplasty for palliation of painful spinal metastases
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 11 sources, which was discussed by the committee. The evidence included 4 systematic reviews, 1 prospective case series, 5 retrospective cohort studies and 1 case report. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: reduction in pain, reduction in use of analgesics (especially opioids) and health-related quality of life.
3.3 The professional experts and the committee considered the key safety outcomes to be: cement leakage, infection, and thermal damage to adjacent structures, including neurological damage.
3.4 Patient commentary was sought but none was received.
Committee comments
3.5 The committee was informed that the procedure can produce rapid relief of pain.
3.6 Different types of radiofrequency ablation devices are used in this procedure, including bipolar and monopolar electrodes.
3.7 The committee were advised that this procedure is primarily used for lytic lesions.
3.8 The committee noted that evidence on the additional benefit of radiofrequency ablation as an adjunct to kyphoplasty or vertebroplasty is limited.
3.9 The committee encourages submission of data to an appropriate register.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
October 2022
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