Abstract No. 52 To Evaluate the Change in Narcotic and Non-narcotic Analgesic Medication Use in Patients with Painful Metastatic Disease to the Spine Before and After Radiofrequency Ablation in Combination with Kyphoplasty

To determine the pattern of oral analgesics usage changes in patients with metastatic disease to the spine, after kyphoplasty and radiofrequency (RF) ablation. Patients with symptomatic metastatic spinal disease who underwent kyphoplasty and RF ablation between 03/2019 and 06/2023 were reviewed in a retrospective manner. There were 74 patients with a median age of 64 yo (range, 31-88) and a M:F ratio of 0.95. The most common primary neoplastic diseases were multiple myeloma (n=21, 28.4%), breast cancer (n=17, 23.0%), lung (n=9, 12.2%), and prostate (n=7, 9.5%). Kyphoplasty and RFA was performed on thoracic vertebra in 31 patients (41.9%), lumbar in 35 patients (47.3%), and thoracolumbar level in 8 patients (10.8%). 44 patients (59. 5%) had kyphoplasty at one vertebral level, 23 patients (31.1%) had two-level kyphoplasty, 6 patients (8.1%) had three-level kyphoplasty, and one patient (1.4%) had a four-level spinal kyphoplasty. The number of non-opioid analgesics and narcotic medications that were taken before, at 1-mo, and 3-mo after the procedure were recorded. Pain relief was evaluated by the visual analog scale (VAS) score. Technical success was achieved in all patients. The median VAS score decreased from 10 (IQR, 8-10) to 2 (IQR, 0-4) at 3 months after the procedure (median change -6 (IQR, -9 to -4), P < 0.001). Table 52.1 demonstrates the counts (and percentages) of the number of different analgesics that patients were taking before the procedure, and at 1-mo and 3-mo after the procedure. There was no significant change in the pattern of non-narcotic analgesic usage. However, there was a significant decrease in usage of narcotics at 1-mo and 3-mo after kyphoplasty compared with baseline. RFA in conjunction with Kyphoplasty provides meaningful clinical improvement in VAS pain scale scores. The requirements for daily oral narcotic medications also decreases after kyphoplasty in patients with metastatic disease to the spine.