Tsoumakidou Georgia, Koch Guillaume, Caudrelier Jean, Garnon Julien, Cazzato Roberto Luigi, Edalat Faramarz, Gangi Afshin
Strasbourg University Hospital, Strasbourg, France.
Cardiovasc Intervent Radiol. 2016 Sep;39(9):1229-38. doi: 10.1007/s00270-016-1402-6. Epub 2016 Jun 21.
The image-guided thermal ablation procedures can be used to treat a variety of benign and malignant spinal tumours. Small size osteoid osteoma can be treated with laser or radiofrequency. Larger tumours (osteoblastoma, aneurysmal bone cyst and metastasis) can be addressed with radiofrequency or cryoablation. Results on the literature of spinal microwave ablation are scarce, and thus it should be used with caution. A distinct advantage of cryoablation is the ability to monitor the ice-ball by intermittent CT or MRI. The different thermal insulation, temperature and electrophysiological monitoring techniques should be applied. Cautious pre-procedural planning and intermittent intra-procedural monitoring of the ablation zone can help reduce neural complications. Tumour histology, patient clinical-functional status and life-expectancy should define the most efficient and least disabling treatment option.
图像引导下的热消融手术可用于治疗多种良性和恶性脊柱肿瘤。小型骨样骨瘤可用激光或射频治疗。较大的肿瘤（骨母细胞瘤、动脉瘤样骨囊肿和转移瘤）可用射频或冷冻消融治疗。脊柱微波消融的文献报道较少，因此应谨慎使用。冷冻消融的一个显著优点是能够通过间歇性CT或MRI监测冰球。应应用不同的热绝缘、温度和电生理监测技术。谨慎的术前规划和术中对消融区域的间歇性监测有助于减少神经并发症。肿瘤组织学、患者的临床功能状态和预期寿命应确定最有效且致残性最小的治疗方案。
