Abstract No. 565 Uninterrupted Systemic Cancer Therapies, Prior Radiotherapy, and Steroids Do Not Increase Infection Risk for Spine Ablation with Kyphoplasty

RF Ablation and Kyphoplasty are within the NCCN Adult Cancer Pain Guidelines alongside multimodal cancer therapies. There is an unmet need for safety data to justify uninterrupted systemic therapies for patients undergoing this procedure. The authors aim to present infection outcomes for spine RFA + kyphoplasty cancer population receiving a wide variety of systemic agents, including immunosuppressive steroids, with inclusion of irradiated levels where vascular supply may be disrupted. Institutional review board–approved retrospective review of all patients undergoing RFA + Kyphoplasty with concurrent uninterrupted systemic therapy between 2019 and 2022 at a single academic institution. Chart review to identify episodes of clinical suspicion for post-procedure infection within 90 days after the procedure were identified and analyzed including imaging studies. Fifty-two RFA + kyphoplasty were performed without interrupting ongoing traditional chemotherapy, targeted therapy, immunotherapy, investigational clinical trial therapy, or hormone therapy in 19/52 (36.5%), 26/52 (50.0%), 19/52 (36.5%), 2/52 (3.8%) and 18/52 (34.6%) respectively. Ongoing treatment with steroids, known to delay wound healing, was present in 24/52 (46.2%) cases. The treatment zone was previously irradiated in 28/52 (53.8%). Within the first 90 days post-procedure, 3 episodes of clinical suspicion of infection were identified by mean clinical follow-up of 9.5 days (range 1-40 days). Detailed review of clinical and imaging workup confirmed infection of the procedural site in 0/3 episodes; 1/3 had urinary tract infection origin, 1/3 had infection of unknown origin with no imaging findings to support the procedural site as a source, 1/3 had an infection of soft tissue related to a separate corpectomy procedure; All 3 were treated with antibiotics by the oncology team. No treatment-site infections occurred when RFA + Kyphoplasty was performed without interrupting systemic therapy, even treating irradiated anatomy and patients with concurrent steroid use.