Introduction Radiofrequency ablation(RFA) is a minimally invasive technique for managing pain from spinal metastases. However, long-term data on its effectiveness and safety remain limited.

Aim of Study To systematically review the analgesic effectiveness and safety of RFA for 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

• RFA used alone or combined with other treatments

• Reported pre- and post-RFA pain assessments

• Published in English

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

Results The search yielded 33 studies encompassing 1418 patients(52.6% females) with 1902 treated lesions. All studies reported achieving partial pain response based on International Consensus Endpoint after Radiation Therapy criteria. 91% of studies showed highly effective pain management(≥4-point reduction on a pain scale to the last follow-up). Moderate effectiveness(≥2-point reduction) was reported in the remaining 3 studies(9%). Lung(28.2%), breast(25.4%)and genitourinary system(11.2%) cancers were the most common primary tumors. The thoracic spine was the most frequent site(47.9), followed by lumbar(47.3%) and sacral(4.5%). No major complications(grade IV-V) were observed. Minor to grade IIIa neurological complications requiring conservative management occurred in 0-16% of patients.

Conclusion This systematic review suggests that RFA, 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.