Introduction Spinal metastases cause significant pain and neurological complications in up to a third of cancer patients. While systemic therapies improve survival, pain management, neurological function preservation, and spinal stability remain crucial palliative goals.

Aim of Study This study aimed to conduct a comprehensive epidemiological analysis on ablation techniques for vertebral metastases to facilitate collaboration between radiation oncologists, surgeons, and neurointerventionalists.

Methods We conducted a systematic literature search based on PRISMA guidelines on ablation techniques for vertebral metastases. Included studies involved at least 3 adult patients with spinal metastases treated with radiofrequency ablation (RFA), microwave ablation(MWA), or cryoablation(alone or combined). Only English publications were considered.

Results From 234 identified articles, 68 met the inclusion criteria. Published between 2006 and 2023, these studies reported ablative procedures treating 3507 lesions in over 2413 patients (median age: 61.5 years, 51.4% female). RFA was the most common technique (73.5%), followed by MWA(22.1%) and cryoablation(4.4%). The thoracic(47.6%) and lumbar spine(45.4%) were the most frequently treated levels. Lung(27.1%), breast(24.3%), genitourinary(11%), gastrointestinal(9.3%), and prostate cancers(5.2%) were the most prevalent primary tumors.Geographically, the majority of studies originated from Europe(39.7%), followed by China(29.4%) and the USA(26.5%).

Conclusion This analysis demonstrates the widespread adoption of ablation techniques for treating spinal metastases across various countries and cancer types. The global reach of these techniques highlights the need for a multidisciplinary approach involving radiation oncologists, surgeons, and neurointerventional radiologists for optimal management of these complex patients.

Disclosure of Interest no.