Introduction Microwave ablation (MWA) is a promising minimally invasive technique for treating spinal metastases, creating larger ablation zones, reducing procedural times, and effectively ablating high-impedance tissues.

Aim of Study To evaluate the efficacy and safety of MWA in managing pain associated with spinal metastases.

Methods A systematic search and analysis were conducted following PRISMA guidelines. Studies were included if they met the following criteria:

• Randomized or non-randomized studies with at least 3 patients (prospective or retrospective)

• Adult patients with spinal metastases

• MWA used alone or combined with other treatments

• Reported pre- and post-MWA pain assessments

• Published in English

Data on demographics, tumor type, lesion location, pain scores, and complications were extracted.

Results The search yielded 14 studies encompassing over 481 patients(M:F=1:1) with 836 treated lesions. All studies reported achieving partial pain response based on International Consensus Endpoint after Radiation Therapy criteria. Additionally, 85.7% of studies showed highly effective pain management (≥4-point reduction on a pain scale to the last follow-up). Lung(35.4%), breast(25%), and gastrointestinal(12.5%) cancers were the most common primary tumors. The thoracic spine was the most frequent site (47%), followed by lumbar (41.3%) and sacral (11.2%). No major complications were observed.

Conclusion This systematic review suggests that MWA, often used in combination with vertebral augmentation, represents a safe and effective treatment for achieving short- to mid-term (24 hours to 6 months) pain control in patients with spinal metastases.

Disclosure of Interest no.