Comparison of post-operative pain scores and opioid use between kyphoplasty and radiofrequency ablation (RFA) systems co
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SCIENTIFIC ARTICLE
Comparison of post-operative pain scores and opioid use between kyphoplasty and radiofrequency ablation (RFA) systems combined with cement augmentation Sumit Jain 1 & Logan Kinch 1,2 & Maunak Rana 1 & Magdalena Anitescu 1 Received: 21 January 2020 / Revised: 14 May 2020 / Accepted: 15 May 2020 # ISS 2020
Abstract Objective This retrospective chart review study aims to compare demographic information, post-operative pain scores, and opioid use following treatment with kyphoplasty alone, OsteoCool™ (Medtronic) system, and SpineSTAR ® (Merit Medicine). Materials and methods Following institutional review board approval, retrospective chart review of 64 patients was examined between January 2011 and December 2017. Inclusion criteria for this study comprised patients greater than 18 years old having metastatic vertebral compression fracture involving the thoracolumbar spine. Exclusion criteria consisted of non-pathologic osteoporotic compression fractures, metastasis in cervical spine, or previous radiofrequency ablation (RFA) treatment. Age at intervention, gender, previous treatment, and nursing recorded VAS score from 0 to 10, with zero representing no pain and 10 representing worst pain were compared. Pain scores documented immediately pre- and post-operatively, as well as 7–14 days post-operatively were targeted for analysis. Post-procedure opioid intake during the first month following surgery was also assessed. Results A total of 63 patients were included in this retrospective analysis. The demographic characteristics between the treatment arms were similar. Difference of square means analysis showed no statistical difference in pain scores at each time interval between the two RFA systems, or was there a statistical difference in pain scores when each RFA system was compared independently to kyphoplasty alone. Chi-squared analysis showed no statistical difference in opioid use between the treatment arms 1 month post-operatively. Discussion To our knowledge, this is the first study that evaluates post-operative pain scores between the two novel RFA systems and kyphoplasty alone. Each system results in improved pain scores post-operatively; however, no additional benefit was seen from the addition of RFA. Keywords Kyphoplasty . Radiofrequency ablation . OsteoCool . SpineStar . Metastatic vertebral lesion
Introduction Approximately 85% of oncology patients with the three most common malignancies (breast, prostate, and lung) experience bony metastatic lesions often resulting in pain and a reduction in quality of life [1]. Moreover, patients with bony spinal * Sumit Jain [email protected] Magdalena Anitescu [email protected] 1
University of Chicago, Chicago, USA
2
University of Virginia, Charlottesville, USA
metastases can develop significant morbidity due to pathologic fractures, spinal cord and nerve root compression, and bone pain [2, 3]. Current multimodal treatment approach consists of opioids and bisphosphonates, surgical fixation, and radiotherapy (RT); however, these can
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