Radiofrequency ablation 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 4 sources, which was discussed by the committee. The evidence included 3 prospective case series and 1 retrospective analysis. 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: infection, thermal damage to adjacent structures, including neurological damage.
3.4 Four commentaries from patients who have had this procedure were discussed by the committee.
Committee comments
3.5 The committee was informed that the procedure can provide rapid pain relief.
3.6 The committee was informed that this procedure is primarily used for sclerotic lesions.
3.7 Different types of radiofrequency ablation devices may be used in this procedure, including bipolar and monopolar electrodes but not all can be used for sclerotic lesions.
3.8 There may be a risk of pathological fracture if cement is not used, but there is a small group of patients for whom the use of cement is contraindicated.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
October 2022
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