The Hopeless Case? Palliative Cryoablation and Cementoplasty Procedures for Palliation of Large Pelvic Bone Metastases.

Abstract:

BACKGROUND:Metastases to the bone are common in cancer patients, and it has been estimated that up to 50% of patients with pelvic bone metastases will not achieve adequate pain control with medications alone. This has led to a paradigm shift over recent years towards the use and development of minimally invasive image-guided treatment options for palliation of bony metastases. Despite these developments, large metastatic lesions are still often considered to be "hopeless cases" that would garner little to no benefit from image-guided intervention. This study is the first large series to describe the novel use of combination percutaneous cryoablation and cementoplasty for palliation of such large metastases to the pelvis. OBJECTIVES:We aim to evaluate the efficacy and safety of image-guided percutaneous cryoablation and cementoplasty for palliation of large pelvic bone metastases. STUDY DESIGN:This retrospective analysis was approved by our institutional review board. This study was conducted from January 2013 to December 2016, where consecutive patients referred for pain management of large pelvic bone metastases underwent combination percutaneous cryoablation and cementoplasty. SETTING:This study took place at a tertiary care center after patients were referred following formal review from a multidisciplinary conference, which was comprised of interventional radiologists, pain management and palliative care physicians, radiation and medical oncologists, and when available, anesthesiologists. METHODS:Forty-eight patients (36 men and 12 women) with a mean cohort age of 77.5 years (range: 52 - 89 years) were referred from the multidisciplinary conference for palliation of pelvic bone metastases. The inclusion criteria included patients with metastases greater or equal to 5.0 cm and significant pain refractory to conventional pain management regimens. All of the patients were deemed not to be surgical candidates. Mean pain scores were collected at numerous time-points along with procedural technical success rates and complication rates. RESULTS:Combination cryoablation and cementoplasty was performed on 48 consecutively referred patients with a 100% technical success rate and no immediate complications. The pain levels demonstrated a significant decrease (P < 0.001) following intervention, with mean pain scores of 7.9 (range: 5 - 10) and 1.2 (range: 0 - 7) throughout the week prior to intervention and at 24 hours post-intervention, respectively. The post-intervention pain scores remained stable at 1 to 9 weeks follow-up (mean: 4.1 weeks). Three patents (6.3%) reported no change in pain following the intervention; however, no patients reported worsened pain. LIMITATIONS:The limitations of this study include its retrospective nature and the length of follow-up, which was often restricted given the life expectancy of our patient cohort. CONCLUSION:Combination cryoablation and cementoplasty is a novel and efficacious treatment option for palliation of large pelvic bone metastases. Marked improvements in pain, as well as mobility and quality of life, are often attainable. KEY WORDS:Pain, palliative care, palliation, percutaneous, cryoablation, cementoplasty, metastases, pelvis, interventional radiology, thermal ablation.

journal_name

Pain Physician

journal_title

Pain physician

authors

Coupal TM,Pennycooke K,Mallinson PI,Ouellette HA,Clarkson PW,Hawley P,Munk PL

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

E1053-E1061

issue

7

eissn

1533-3159

issn

2150-1149

journal_volume

20

pub_type

杂志文章
  • Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion for Degenerative Lumbar Diseases: A Consecutive Case Series with Mean 2-Year Follow-Up.

    abstract:BACKGROUND:Conventional open surgical procedures may cause massive dissections of the spine, higher perioperative complications, prolonged hospitalization, protracted rehabilitation programs and recovery. Percutaneous endoscopic lumbar interbody fusion (PELIF) is an evolving treatment option. OBJECTIVES:To present the...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Jin M,Zhang J,Shao H,Liu J,Huang Y

    更新日期:2020-03-01 00:00:00

  • Percutaneous disc decompression using coblation (nucleoplasty) in the treatment of chronic discogenic pain.

    abstract::Clinical outcome data was analyzed for 67 patients with contained disc herniation who underwent percutaneous disc decompression procedure using Coblation(R) technology, also referred to as Nucleoplasty after failing to respond to conservative management. Patients presented with clinical symptoms of discogenic low back...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Singh V,Piryani C,Liao K,Nieschulz S

    更新日期:2002-07-01 00:00:00

  • Radiocontrast media allergic reactions and interventional pain practice--a review.

    abstract:BACKGROUND:Millions of interventional pain procedures are performed each year in the United States. Interventional pain physicians commonly administer radiocontrast media (RCM) under fluoroscopy for these procedures. However, RCM can cause various types of hypersensitivity or allergic type reactions, in an acute or de...

    journal_title:Pain physician

    pub_type: 杂志文章,评审

    doi:

    authors: Newmark JL,Mehra A,Singla AK

    更新日期:2012-09-01 00:00:00

  • Optimization of Postoperative Intravenous Patient-Controlled Analgesia with Opioid-Dexmedetomidine Combinations: An Updated Meta-Analysis with Trial Sequential Analysis of Randomized Controlled Trials.

    abstract:BACKGROUND:It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES:The aim of this study is to assess the efficacy and safety of opioid-DEX combinatio...

    journal_title:Pain physician

    pub_type: 杂志文章,meta分析,评审

    doi:

    authors: Peng K,Zhang J,Meng XW,Liu HY,Ji FH

    更新日期:2017-11-01 00:00:00

  • Caudal normal saline injections for the treatment of post-dural puncture headache.

    abstract:BACKGROUND:Post-dural puncture headache (PDPH) is the most common complication of procedures in which the dura mater is penetrated. OBJECTIVES:To evaluate the effectiveness of caudal saline injections as a therapeutic approach for handling post-dural puncture headache. STUDY DESIGN:Prospective observational study bet...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Abdulla S,Abdulla W,Eckhardt R

    更新日期:2011-05-01 00:00:00

  • Pulsed Radiofrequency to the Dorsal Root Ganglion in Acute Herpes Zoster and Postherpetic Neuralgia.

    abstract:BACKGROUND:Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsal root ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is an important region for pain signal transduction. Sustained abnormal electrical activity to the spinal cord via the DRG in acute he...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Kim K,Jo D,Kim E

    更新日期:2017-03-01 00:00:00

  • The effect of lumbar sympathetic ganglion block on gynecologic cancer-related lymphedema.

    abstract:BACKGROUND:Eighteen to 25% of patients after gynecological cancer treatment suffer from lower limb lymphedema (LLL) that decreases the quality of life of gynecological cancer survivors. Lumbar sympathetic ganglion block (LSGB) is widely used in practice for the evaluation and management of sympathetically mediated pain...

    journal_title:Pain physician

    pub_type: 临床试验,杂志文章

    doi:

    authors: Woo JH,Park HS,Kim SC,Kim YH

    更新日期:2013-07-01 00:00:00

  • Chronic Pain Practices: An Evaluation of Positive and Negative Online Patient Reviews.

    abstract:BACKGROUND:The role of patient satisfaction continues to play an important role in health care quality measures. The use of online review platforms has been adopted by patients to share their perceptions about the quality of care provided by physicians. Chronic pain practice has unique challenges regarding patient sati...

    journal_title:Pain physician

    pub_type: 杂志文章,评审

    doi:

    authors: Orhurhu MS,Salisu B,Sottosanti E,Abimbola N,Urits I,Jones M,Viswanath O,Kaye AD,Simopoulos T,Orhurhu V

    更新日期:2019-09-01 00:00:00

  • Opioid tolerance--a predictor of increased length of stay and higher readmission rates.

    abstract::The increasing use of opioids to manage pain in the United States over the last decade has resulted in a subset of our population developing opioid tolerance. While the management of opioid tolerant patients during acute episodes of care is well known to be a challenge amongst health care providers, there is little in...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Gulur P,Williams L,Chaudhary S,Koury K,Jaff M

    更新日期:2014-07-01 00:00:00

  • Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study.

    abstract:BACKGROUND:Extensive decompression with laminectomy, where appropriate, is often still described as the method of choice when operating on degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the sur...

    journal_title:Pain physician

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Komp M,Hahn P,Oezdemir S,Giannakopoulos A,Heikenfeld R,Kasch R,Merk H,Godolias G,Ruetten S

    更新日期:2015-01-01 00:00:00

  • High Voltage Pulsed Radiofrequency for the Treatment of Refractory Neuralgia of the Infraorbital Nerve: A Prospective Double-Blinded Randomized Controlled Study.

    abstract:BACKGROUND:A recent study showed that 50% of patients who suffered from refractory neuralgia of the infraorbital nerve obtained satisfactory efficacy after pulsed radiofrequency (PRF) treatment. A pilot study showed that increasing the output voltage of PRF significantly improved the efficacy for trigeminal neuralgia; ...

    journal_title:Pain physician

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Luo F,Wang T,Shen Y,Meng L,Lu J,Ji N

    更新日期:2017-05-01 00:00:00

  • Comparison of the Efficacy and Safety of Bone-filling Mesh Container and Simple Percutaneous Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures.

    abstract:BACKGROUND:Bone cement leakage in patients with vertebral fracture limits the use of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Finding a method to reduce bone cement leakage is clinically rather important. OBJECTIVE:To compare the efficacy and safety of bone-filling mesh containers (BFMCS) ...

    journal_title:Pain physician

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: He CJ,Liu GD

    更新日期:2018-05-01 00:00:00

  • Pre-emptive and multi-modal perioperative pain management may improve quality of life in patients undergoing spinal surgery.

    abstract:BACKGROUND:Compared to an abundance of data on surgical techniques for degenerative spine conditions and the outcomes thereof, little is available to guide optimal perioperative pain management after spinal surgery. The aim of this study was to survey patterns of perioperative pain management after spinal surgery and t...

    journal_title:Pain physician

    pub_type: 杂志文章,多中心研究

    doi:

    authors: Lee BH,Park JO,Suk KS,Kim TH,Lee HM,Park MS,Lee SH,Park S,Lee JY,Ko SK,Moon SH

    更新日期:2013-05-01 00:00:00

  • Superior hypogastric plexus combined with ganglion impar neurolytic blocks for pelvic and/or perineal cancer pain relief.

    abstract:BACKGROUND:The superior hypogastric plexus (SHGP) carries afferents from the viscera of the lower abdomen and pelvis. Neurolytic block of this plexus is used for reducing pain resulting from malignancy in these organs. The ganglion impar (GI) innervats the perineum, distal rectum, anus, distal urethra, vulva, and dista...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Ahmed DG,Mohamed MF,Mohamed SA

    更新日期:2015-01-01 00:00:00

  • Pain Relief in CRPS-II after Spinal Cord and Motor Cortex Simultaneous Dual Stimulation.

    abstract:UNLABELLED:We describe a case of a 30-year-old woman who suffered a traumatic injury of the right brachial plexus, developing severe complex regional pain syndrome type II (CRPS-II). After clinical treatment failure, spinal cord stimulation (SCS) was indicated with initial positive pain control. However, after 2 years ...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Lopez WO,Barbosa DC,Teixera MJ,Paiz M,Moura L,Monaco BA,Fonoff ET

    更新日期:2016-05-01 00:00:00

  • Comparison of Intraarticular Pulsed Radiofrequency and Intraarticular Corticosteroid Injection for Management of Cervical Facet Joint Pain.

    abstract:BACKGROUND:Disorders of the facet joints are some of the most common sources of chronic spinal pain. Facet joint pain is responsible for approximately 50% of patients with chronic neck pain. Pulsed radiofrequency (PRF) stimulation, after placing needle electrodes into the joint space, has been recently reported for the...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Lim JW,Cho YW,Lee DG,Chang MC

    更新日期:2017-09-01 00:00:00

  • An introduction to an evidence-based approach to interventional techniques in the management of chronic spinal pain.

    abstract::Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Clinical practice guidelines present statements of best practice based on a thorough evaluation of the evidence from published studies ...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Manchikanti L,Singh V,Helm S 2nd,Schultz DM,Datta S,Hirsch JA,American Society of Interventional Pain Physicians.

    更新日期:2009-07-01 00:00:00

  • Delayed Initiation of Supplemental Pain Management is Associated with Postherpetic Neuralgia: A Retrospective Study.

    abstract:BACKGROUND:Acute pain is a risk factor for developing postherpetic neuralgia (PHN), the most common complication of herpes zoster (HZ). Supplemental analgesics are frequently used in the treatment of acute herpetic pain. However, there are insufficient data regarding when to begin supplemental analgesics, and it is unk...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Xing X,Sun K,Yan M

    更新日期:2020-01-01 00:00:00

  • Corticosteroids: Review of the History, the Effectiveness, and Adverse Effects in the Treatment of Joint Pain.

    abstract:BACKGROUND:Corticosteroids have been used for the past 70 years in the treatment of various musculoskeletal conditions. This includes its use for joint pain such as rheumatoid arthritis and osteoarthritis. OBJECTIVES:A narrative review of the literature from its initial discovery to the present day to summarize the re...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Stone S,Malanga GA,Capella T

    更新日期:2021-01-01 00:00:00

  • Comparison of Clinical Efficacy of Epidural Injection With or Without Steroid in Lumbosacral Disc Herniation: A Systematic Review and Meta-analysis.

    abstract:BACKGROUND:Epidural injection is performed for treatment of back and radicular pain in patients with lumbosacral disc herniation (LDH). Steroids are usually administered to effectively remove inflammatory mediators, and local anesthetics or saline also contribute to pain reduction by washing out chemical mediators or b...

    journal_title:Pain physician

    pub_type: 杂志文章,meta分析

    doi:

    authors: Lee JH,Kim DH,Kim DH,Shin KH,Park SJ,Lee GJ,Lee CH,Yang HS

    更新日期:2018-09-01 00:00:00

  • Treatment of Neuropathic Pain Using Pulsed Radiofrequency: A Meta-analysis.

    abstract:BACKGROUND:Neuropathic pain (NP) is a major public health problem worldwide. Because of the unclear mechanism of NP, its treatment is one of the most difficult medical problems. As a targeted, noninvasive, safe therapy, pulsed radiofrequency (PRF) provides a new method for the treatment of NP; however, its effect on th...

    journal_title:Pain physician

    pub_type: 杂志文章,meta分析

    doi:

    authors: Shi Y,Wu W

    更新日期:2016-09-01 00:00:00

  • Pudendal Neuralgia Due to Pudendal Nerve Entrapment: Warning Signs Observed in Two Cases and Review of the Literature.

    abstract::Pudendal neuralgia is a chronic neuropathic pelvic pain that is often misdiagnosed and inappropriately treated. The Nantes criteria provide a basis for the diagnosis of pudendal neuralgia due to pudendal nerve entrapment. The 5 essential diagnostic criteria are pain situated in the anatomical territory of the pudendal...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Ploteau S,Cardaillac C,Perrouin-Verbe MA,Riant T,Labat JJ

    更新日期:2016-03-01 00:00:00

  • Candida spondylodiscitis: an unusual case of thoracolumbar pain with review of imaging findings and description of the clinical condition.

    abstract::Spondylodiscitis is an unusual but important cause of back pain. Patients with spinal infections typically present with severe sharp aching pain, malaise, fever, and percussion tenderness over the affected area. Early identification of the responsible organism is essential for adequate and prompt treatment. Fungal spo...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Torres-Ramos FM,Botwin K,Shah CP

    更新日期:2004-04-01 00:00:00

  • Post-lumbar surgery complex regional pain syndrome.

    abstract:BACKGROUND:This case report identifies a patient with complex regional pain syndrome Type 2 (causalgia) with sympathetically maintained pain in a distal extremity associated with an anterior sacroiliac fusion with local bone graft. CASE DESCRIPTION:A sacroiliac fusion was undertaken due to chronic back pain that was t...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Fish DE

    更新日期:2005-07-01 00:00:00

  • The role of diagnostic selective nerve root blocks in the management of spinal pain.

    abstract::Biochemical mechanisms to explain pain generation began relatively recently. Evaluating pain originating from the spine can be challenging because no historical or physical examination findings are sufficiently sensitive or specific for identifying each of the myriad of potential pain generators. These discrete anatom...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Slipman CW,Issac Z

    更新日期:2001-07-01 00:00:00

  • Long-Term Effectiveness and Tolerability of Pain Treatment with Tapentadol Prolonged Release.

    abstract:BACKGROUND:The central analgesic tapentadol prolonged release (PR) has proven effective and generally well tolerated in a broad range of chronic pain conditions. Long-term data of its use are still scarce. OBJECTIVES:To evaluate long-term effectiveness, tolerability, and safety of tapentadol PR in patients with severe...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Mateos RG,Bernal DS,Morera LMT,Ferri CM,Escobar AE

    更新日期:2021-01-01 00:00:00

  • Chronic Smoking is Not Associated with Increased Postoperative Opioid Use in Patients with Lung Cancer or Esophageal Cancer.

    abstract:BACKGROUND:Chronic smokers show differences in pain sensitivity compared to healthy non-smokers. Yet, no study to date has examined whether smoker status has an effect on postoperative pain. OBJECTIVE:We aim to examine a possible correlation between preoperative smoking and postoperative opioid dose based on the hypot...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Oh TK,Jeon JH,Lee JM,Kim MS,Kim JH,Lee SJ,Eom W

    更新日期:2018-01-01 00:00:00

  • What is the Correlation Between Facet Joint Radiofrequency Outcome and Response to Comparative Medial Branch Blocks?

    abstract:BACKGROUND:Facet joint pain is a common cause of low back pain. There are no physical exam findings that provide a reliable diagnosis. Diagnosis is made by medial branch block injections (MBB). Once the source of pain has been determined, radiofrequency neurotomy (RFN) can be performed. Previous studies have shown that...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Holz SC,Sehgal N

    更新日期:2016-03-01 00:00:00

  • Review of occupational medicine practice guidelines for interventional pain management and potential implications.

    abstract::In the modern day environment, workers' compensation costs continue to be a challenge, with a need to balance costs, benefits, and quality of medical care. The cost of workers' compensation care affects all stakeholders including workers, employers, providers, regulators, legislators, and insurers. Consequently, a con...

    journal_title:Pain physician

    pub_type: 杂志文章,评审

    doi:

    authors: Manchikanti L,Singh V,Derby R,Helm S 2nd,Trescot AM,Staats PS,Prager JP,Hirsch JA

    更新日期:2008-05-01 00:00:00

  • Quality assurance for interventional pain management procedures.

    abstract:BACKGROUND:Over the last decade various guidelines for quality assurance in pain medicine have been published for cancer pain, acute postoperative pain and other pain conditions. However, quality assurance for interventional pain management procedures has yet to be addressed. An interventional pain program should at le...

    journal_title:Pain physician

    pub_type: 杂志文章

    doi:

    authors: Zhou Y,Furgang FA,Zhang Y

    更新日期:2006-04-01 00:00:00