Abstract No. 268 Articulating versus Non-articulating Arm Radiofrequency Ablation (RFA) System in Combination with Kyphoplasty for the Treatment of Painful Spine Metastases: Comparison of VAS, ECOG, Karnofsky, ODI, Radiation, and Cement Volumes

This study compares outcomes of RFA in combination with kyphoplasty for the treatment of patients with painful metastatic disease to the spine, using articulating (Merit STAR) versus non-articulating (Medtronic OsteoCool) RFA systems. All patients with painful metastatic spinal disease who underwent kyphoplasty and RFA between 03/2019 and 06/2023 were reviewed in a retrospective manner. Of 74 patients, 44 (59.5%) who had kyphoplasty at a single vertebral level only were included in the study. 31 patients (70.5%) had RFA using a non-articulating system (Medtronic OsteoCool) and 13 patients (29.5%) had RFA using an articulating arm system (Merit STAR). The mean age was 63.1 yo (SD: 10.4), and M:F ratio 0.76. Most common neoplasms: Multiple myeloma (n=10, 22.7%), breast cancer (n=10, 22.7%), lung (n=5, 11.4%). Pain relief was evaluated by the VAS and ODI score, performance status by KPSS and ECOG score before and within 3-months after the procedure. The highest documented VAS, ODI, KPSS, and ECOG scores pre and post-procedure were recorded (Table 268.1). Technical success was achieved in all patients. Kyphoplasty and RF ablation was performed on thoracic vertebra in 20 patients (45.5%) and lumbar vertebra in 24 patients (54.5%). The median VAS decreased from 10 (IQR, 8-10) to 3 (IQR, 0-4.75) (P < 0.001), median ODI score decreased from 60.0 (IQR, 46-77.5) to 20.0 (IQR, 14.5-33.5) (p=0.001), median KPSS score increased from 50 (IQR, 40-70) to 80 (IQR, 50-90) (P =0.008), and median ECOG score decreased from 3 (IQR, 2-3) to 1 (IQR, 0-2.0) within 3 months after the procedure (P = 0.001). In the subgroup analysis, the radiation exposure and outcome measures were not clinically and statistically different. Cement volumes, radiation exposure, pain, performance, and disability scores are not clinically or statistically different with either the articulating or non-articulating RFA system.