Cryosurgery - Bones

SUMMARY

In case of primitive or metastatic bone tumors cryoablation is a technique that excels in respect to the others used up to now (1). The demolitive surgical techniques, radiotherapy and radiofrequency, are less effective in many cases, considering the speed of action on pain and the low invasiveness of cryosurgery, thanks to the possibility of monitoring very well the area that has to be hit, without touching organs and surrounding sensitive areas (2). We use thin needles called cryoprobes, which are inserted into the bones where the tumor lesions are hidden under TAC guide, or with open surgery under visual control of the surgeon. After about 40 minutes, they kill the cancer cells and destroy the nerve endings giving almost immediate relief to the painful symptoms.

GENERAL INFORMATION

Bones have many functions within our body: support and cushioning, protection (as skull for brain and chest for heart and lungs), and production of blood cells (white blood cells, platelets and red cells).

All the cells that costitute the bone tissue (osteoblasts and osteoclasts) may give origine to tumors.

Diagnosis

The most frequent bone generated tumors are osteosarcoma and chondrosarcoma, there are also tumors that develope inside the bones from cancer cells released by a neoplasia grown somewhere else. 

These tumors can cause localized swelling and pain, fractures or impediment to movement. Diagnosis is done with simple X-ray, CT, MRI, PET CT.

Therapy

To Remove a bone tumor,  using classical surgical methods, often emplies the necessity to sacrifie important segments of the body.

With Cryoablation it is possible to be more conservative in comparison to  other therapies  (1), such as, for example, the surgical extirpative procedures, radiotherapy and radio frequency. Also important to note is the fast curative effect on pain  as well as the possibility to monitor the targeted area sparing sensitive surrounding organs and structures (2).

For the above reasons cryoablation is considered the most innovative technology in pain therapy and the most cutting edge in order to achieve excellent results in the shortest time. 

  1. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor.
    Cardiovasc Intervent Radiol. 2015 Jul 1.
    Panizza PS, de Albuquerque Cavalcanti CF, Yamaguchi NH, Leite CC, Cerri GG, de Menezes MR.
  2. Cryoablation of sternal metastases for pain palliation and local tumor control.
    J Vasc Interv Radiol. 2014 Nov;25(11):1665-70. doi: 10.1016/j.jvir.2014.08.011. Epub 2014 Sep 23.
    Hegg RM1, Kurup AN2, Schmit GD1, Weisbrod AJ1, Atwell TD1, Olivier KR3, Moynihan TJ4, Callstrom MR1.
  3. The application of cryoprobe therapy in orthopedic oncology.
    2014 Aug;37(8):536-40. doi: 10.3928/01477447-20140728-06.
    Walker K, Lindeque B.
  4. Feasibility of percutaneous cryoablation of vertebral metastases under local anaesthesia in ASAIII patients.
    Motta A, Caltabiano G, Palmucci S, Failla G, Basile A.
    Eur J Radiol. 2017 Oct;95:13-17. doi: 10.1016/j.ejrad.2017.07.011. Epub 2017 Jul 23.
  5. Spine Cryoablation: Pain Palliation and Local Tumor Control for Vertebral Metastases.
    Tomasian A, Wallace A, Northrup B, Hillen TJ, Jennings JW.
    AJNR Am J Neuroradiol. 2016 Jan;37(1):189-95. doi: 10.3174/ajnr.A4521. Epub 2015 Oct 1.