About OsteoCool RF Ablation for Healthcare Professionals
KNOW THE FACTS
Medtronic offers radiofrequency ablation to help treat painful bone tumours. Patients with metastatic bone cancer may be treated with conventional therapies such as opioids, chemotherapy, or radiation therapy for pain palliation. With OsteoCoolTM RF Ablation, physicians can address pain associated with metastatic bone tumours when conventional therapies aren’t effective, are too slow acting, or cause unacceptable side effects.1
Bone is invaded in 60-80% of patients with metastatic disease,2 most frequently among patients with primary malignancies of the breast, prostate, and lung.3
More than 80% of bone metastases are found in the axial skeleton, and the spine, pelvis, and ribs are often the earliest sites of disease.4
Bone metastases can impact patients’ quality of life, producing complications such as pain, fractures, and decreased mobility.5 In addition to these symptoms, pain from metastases can cause mood changes such as depression and anxiety.6
Procedure Goals
Clinical Evidence for RFA + AUGMENTATION VERSUS AUGMENTATION ALONE FOR SPINAL METASTASES
Metastatic lesions of the spine may become painful due to neurological compression, pathologic fracture, or other biochemical mechanisms.7 While some pain derives from biological sources such as cytokine release, other pain sources are mechanical such as tumour periosteal pressure and tumour impingement on neural structures.8
The goal of bone tumour RFA is to eradicate these sources of pain, independent of the mechanical stabilisation need.
Medtronic’s RF ablation device, the OsteoCool RF Ablation System, is coaxial, bipolar technology that uses algorithms designed to perform optimally in bone. With the OsteoMapSM Technique, you can be confident in your anterior and posterior margins to ensure you are covering the entire tumour. Where indicated, you can use the same OsteoCool bone access for subsequent procedures such as cementoplasty (e.g., kyphoplasty, sacroplasty, or vertebroplasty) to stabilise the fracture.
Case review
METASTATIC DISEASE CASE STUDY USING OSTEOCOOL
“This particular case became a learning experience for me to reach out to our local radiation oncologists to talk about who should be treated first when it comes to patients at risk for future fracture. We have the same goals and obligations to provide the best care for these patients. We know we need to address these patients’ pain quickly, stabilize fractures and get ahead of delayed skeletal events especially in axial loading areas with lytic metastases. With the addition of OsteoCool, treatment options for these patients have expanded. When I have completed the ablation, I can stabilize with kyphoplasty or vertebroplasty right away where indicated. I do this using the same access channel.” – Jason Levy, MD, Northside Hospital, Atlanta, GA
PATIENT HISTORY
- 42-year-old female
- Breast Sarcoma
- Pain Score 10/10
- Multifraction EBRT completed one week prior to consult
- Unable to ambulate and off systemic therapy protocol
IMAGES PRIOR TO ABLATION
- T5 fracture
- No neuropathy
ABLATION
- T5 ablation
RESULT SUMMARY/UPDATE
- Pain score after 4/10 next morning
- Up and out of bed doing PT
- Back on systemic therapy
Contact Us About OsteoCool
Speak to your local Medtronic representative to learn more about OsteoCool Radiofrequency Ablation.
Request a call
IMPORTANT SAFETY INFORMATION
INDICATIONS
- Intended for palliative treatment in spinal procedures by ablation of metastatic malignant lesions in a vertebral body
- Coagulation and ablation of tissue in bone during surgical procedures including palliation of pain associated with metastatic lesions involving bone in patients who have failed or are not candidates for standard therapy
- Ablation of benign bone tumours such as osteoid osteoma
RISKS
- As a consequence of electrosurgery, damage to surrounding tissue through iatrogenic injury could occur
- Pulmonary embolism
1
Sabharwal et al. Image-Guided Ablation Therapy of Bone Tumors. Semin Ultrasound CT MRI. 2009; 30: 78-90.
2
Schulman et al. Economic Burden of Metastatic Bone Disease in the U.S. Cancer, 2007; 109(11):2334-2342.
3
Kurup AN, Callstrom MR. J Vasc Interv Radiol. 2010; 21(8 Suppl); S242-50.
4
Nielson et al. Bone Metastases: Pathophysiology and Management Policy. J Clin Oncol. 1991; 9(3):509-524.
5
Goetz et al. Percutaneous Image-Guided Radiofrequency Ablation of Painful Metastases Involving Bone: A Multicenter Study. J Clin Oncol. 2004;22(2):300-306.
6
Spiegel D, et al. Pain and depression in patients with cancer. Cancer, 1994; 74:2570-2578.
7
Wallace AN, Greenwood TJ, Jennings JW. Radiofrequency ablation and vertebral augmentation for palliation of painful spinal metastases. J Neurooncol. 2015; 124(1); 15; 707-712.
8
Cazzato RL, Garnon J, Caudrelier J, et al. Low-power bipolar radiofrequency ablation and vertebral augmentation for the palliative treatment of spinal malignancies. Int J Hyperthermia. 2018; 34 (8): 1282-1288.