Date of Presentation
5-2-2024 12:00 AM
College
Rowan-Virtua School of Osteopathic Medicine
Poster Abstract
Background: It is estimated that metastases from primary malignant neoplasms affect the spine around 30%-70% of the time. Many times, these osteolytic tumors will cause the degradation of the vertebrae, leaving patients in a tremendous amount of pain, disability, and dependence on opioids as analgesics. Microwave ablation (MWA) followed by vertebroplasties (VP) has been a developing treatment for such a condition; however, there are no systematic reviews or meta-analyses examining the method’s effectiveness thus far.
Purpose: This systematic review and meta-analysis analyzes the 4-week and 12-week outcomes of patients with metastatic spinal cancer treated with the combinatorial treatment of microwave ablation followed by a vertebroplasty.
Methods: The systematic review and meta-analysis followed the 2020 PRISMA guidelines. Five online databases (Cochrane, Embase, PubMed, Web Of Science, Scopus) were screened. Included were studies that included 4-week and 12-week Visual Analogue Scales (VAS) scores, Oswestry Disability Index (ODI) measures, and Daily Morphine Consumption (DMC). Four studies fit our inclusion criteria, yielding a sample size of 117 patients.
Results: Our results portray strong clinically significant results of utilizing MWA with VP at both 4-weeks and 12-weeks. At 4-weeks, the effect size for the reduction of VAS, ODI, and DMC were Cohen’s d = 4.00, Cohen’s d = 3.29, Cohen’s d = 4.50, respectively. At 12-weeks, the reduction in VAS and DMC had an effect size of Cohen’s d = 4.34 and Cohen’s d = 4.56, respectively. Comparing the 4-week and 12-week VAS scores, there was a difference in Cohen’s d = 0.34, in favor of 12-weeks, signifying a possible clinical significance of even further reduction of VAS scores as time progresses.
Conclusion: Utilizing microwave ablation in combination with a vertebroplasty greatly reduced pain, disability, and opioid consumption in patients with metastatic spinal cancer over a 4-week and 12-week timeline. However, with only 117 patient data available to be analyzed, future studies are needed in order to increase the available sample size. Furthermore, comparative randomized controlled trials assessing the significance of utilizing MWA with VP, compared to VP alone could further exemplify the importance of MWA to the treatment.
Keywords
Microwave Ablation, Vertebroplasty, Metastatic Spinal Cancer, Opioid, Orthopedic Surgery, Spine, Neoplasms, Neoplasm Metastasis, Pain Management
Disciplines
Anesthesia and Analgesia | Medicine and Health Sciences | Musculoskeletal Diseases | Musculoskeletal System | Neoplasms | Nervous System | Neurology | Oncology | Orthopedics | Pathological Conditions, Signs and Symptoms | Therapeutics
Document Type
Poster
DOI
10.31986/issn.2689-0690_rdw.stratford_research_day.211_2024
Included in
Anesthesia and Analgesia Commons, Musculoskeletal Diseases Commons, Musculoskeletal System Commons, Neoplasms Commons, Nervous System Commons, Neurology Commons, Oncology Commons, Orthopedics Commons, Pathological Conditions, Signs and Symptoms Commons, Therapeutics Commons
Utilizing Microwave Ablation in Combination with Vertebroplasty Is an Effective Method in Reducing Cancer Related Back Pain, Disability, and Opioid Use: A Systematic Review and Meta-Analysis
Background: It is estimated that metastases from primary malignant neoplasms affect the spine around 30%-70% of the time. Many times, these osteolytic tumors will cause the degradation of the vertebrae, leaving patients in a tremendous amount of pain, disability, and dependence on opioids as analgesics. Microwave ablation (MWA) followed by vertebroplasties (VP) has been a developing treatment for such a condition; however, there are no systematic reviews or meta-analyses examining the method’s effectiveness thus far.
Purpose: This systematic review and meta-analysis analyzes the 4-week and 12-week outcomes of patients with metastatic spinal cancer treated with the combinatorial treatment of microwave ablation followed by a vertebroplasty.
Methods: The systematic review and meta-analysis followed the 2020 PRISMA guidelines. Five online databases (Cochrane, Embase, PubMed, Web Of Science, Scopus) were screened. Included were studies that included 4-week and 12-week Visual Analogue Scales (VAS) scores, Oswestry Disability Index (ODI) measures, and Daily Morphine Consumption (DMC). Four studies fit our inclusion criteria, yielding a sample size of 117 patients.
Results: Our results portray strong clinically significant results of utilizing MWA with VP at both 4-weeks and 12-weeks. At 4-weeks, the effect size for the reduction of VAS, ODI, and DMC were Cohen’s d = 4.00, Cohen’s d = 3.29, Cohen’s d = 4.50, respectively. At 12-weeks, the reduction in VAS and DMC had an effect size of Cohen’s d = 4.34 and Cohen’s d = 4.56, respectively. Comparing the 4-week and 12-week VAS scores, there was a difference in Cohen’s d = 0.34, in favor of 12-weeks, signifying a possible clinical significance of even further reduction of VAS scores as time progresses.
Conclusion: Utilizing microwave ablation in combination with a vertebroplasty greatly reduced pain, disability, and opioid consumption in patients with metastatic spinal cancer over a 4-week and 12-week timeline. However, with only 117 patient data available to be analyzed, future studies are needed in order to increase the available sample size. Furthermore, comparative randomized controlled trials assessing the significance of utilizing MWA with VP, compared to VP alone could further exemplify the importance of MWA to the treatment.