PurposeThe purpose of this review is to become familiar with the most
common indications for imaging guided percutaneous bipolar
radiofrequency ablation, to learn about different technical
considerations during performance providing the current evidence.
Controversies concerning products will be addressed.MethodsWe performed
a literature review excluding non-English studies and case reports. All
references of the obtained articles were also evaluated for any
additional information.ResultsRFA achieves cytotoxicity by raising
target area temperatures above 60 degrees C, and may be used to achieve
total necrosis of lesions smaller than 3 cm in diameter, to debulk and
reduce the pain associated with larger lesions, to prevent pathological
fractures due to progressive osteolysis or for cavity creation aiming
for targeted cement delivery in case of posterior vertebral wall
breaching. Protective ancillary techniques should be used in order to
increase safety and augment efficacy of RFA in the
spine.ConclusionPercutaneous radiofrequency ablation of vertebral
lesions is a reproducible, successful and safe procedure. Ablation
should be combined with vertebral augmentation in all cases. In order to
optimize maximum efficacy a patient- and a lesion-tailored approach
should both be offered focusing upon clinical and performance status
along with life expectancy of the patient as well as upon lesion
characteristics
