Two studies, presented this week at the 94^th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), concluded a novel technique can improve outcomes for patients with vertebral compression fractures (VCF) caused by malignant tumors in the spine. The American Cancer Society estimates 30 to 70 percent of more than half a million people who die annually of cancer have metastatic disease and 10 percent of the 750,000 vertebral compression fractures that occur each year are caused by metastatic spine tumors.

This new treatment uses a plasma mediated medical device, the Cavity SpineWand, developed by ArthroCare to debulk, or reduce, the lesion. Bone cement can be subsequently injected to stabilize the fracture. Stabilization of the fracture helps to ease the pain associated with VCFs. The combined therapies have been successfully used in tandem with radiation and chemotherapy.

One study, led by Mark Perman, M.D., an ArthroCare consultant, examined a synergistic approach to treating VCFs secondary to spinal metastases. The approach consisted of three treatments: removing tumor tissue to create a cavity, filling the cavity with bone cement to stabilize the vertebral body and then treating the tumor with either radiosurgery or external beam radiation to reduce the remaining tumor burden. A separate study by Bassem Georgy, M.D. found removing tumor tissue with the Cavity SpineWand increased control and predictability during cement injection.

“Patients with VCFs are typically in extreme pain and radiation therapy alone, which is critical to treating the cancer, may be ineffective as a palliative option,” said Dr. Perman, Chief of Radiosurgery, The CyberKnife Center at North Florida Radiology. “With this synergistic approach, my patients receive quick pain relief and mechanical stability without delaying tumor treatment, which can dramatically improve quality of life.”

The study led by Dr. Perman, “Vertebroplasty and Radiation Therapy: Synergistic Treatment of Pathologic Compression Fractures,” involved seven patients suffering from painful VCFs. After treatment, all but one patient reported significant pain relief immediately following the treatments which was sustained or reduced further during follow-up with radiation therapy. Pain levels were assessed at three different time points over the course of three months.

In the study “Percutaneous Anterior Column Stabilization in Metastatic Spine Lesions: Value of Plasma-mediated Radiofrequency Ablation and Cement Augmentation,” Dr. Georgy, interventional neuro-radiologist and Associate Professor as University of California San Diego, and a consultant to ArthroCare, reported 82.3 percent success in placing bone cement in the anterior 2/3 of the vertebral body, which is commonly believed to be a key factor in stabilizing the spine. The study included 30 patients (34 levels) with 25 (83 percent) reporting pain relief following cement augmentation.

The Cavity SpineWand is a minimally invasive device that uses a plasma based technology called Coblation to create a cavity in a malignant lesion. The Cavity SpineWand is inserted through a cannula to reach the tumor inside the vertebrae. Once inside, a low-heat, plasma cloud removes tumor tissue while minimizing damage to surrounding healthy tissue. Medical grade bone cement is subsequently injected to stabilize the fracture using the space created by the reduction of the lesion. Following vertebroplasty, patients report significant pain relief, often within 72 hours post procedure.

This minimally invasive procedure is typically performed by a specialist in consultation with a radiation oncologist. Over 200 physicians in the United States have been trained in these treatments to date.