1 Recommendations

Guidance

1.1 Evidence on the safety and efficacy of radiofrequency ablation for palliation of painful spinal metastases is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

1.2 Clinicians wanting to do radiofrequency ablation for palliation of painful spinal metastases should:

Inform the clinical governance leads in their healthcare organisation.
Give people (and their families and carers as appropriate) clear written information to support shared decision making, including NICE's information for the public.
Ensure that people and their families and carers understand the procedure's safety and efficacy, and any uncertainties about these.
Audit and review clinical outcomes of everyone having the procedure. The main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedure outcomes audit tool (for use at local discretion).
Discuss the outcomes of the procedure during their annual appraisal to reflect, learn and improve.

1.3 Healthcare organisations should:

Ensure systems are in place that support clinicians to collect and report data on outcomes and safety for everyone having this procedure.
Regularly review data on outcomes and safety for this procedure.

1.4 Patient selection should be done by a multidisciplinary team. The procedure should only be done by clinicians with training and expertise in vertebral interventions.

1.5 NICE encourages further research into the procedure. This should report details of patient selection, type of tumour and interventional procedures used.