RT Journal Article SR Electronic T1 P176 Percutaneous microwave ablation of painful spinal metastasis: an updated systematic review of analgesia and safety JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP A122 OP A122 DO 10.1136/jnis-2024-ESMINT.211 VO 16 IS Suppl 2 A1 Scaggiante, Jacopo A1 Pedicelli, Alessandro A1 Marsico, Salvatore A1 Casà, Calogero A1 Miccichè, Francesco A1 Garignano, Giuseppe A1 Alexandre, Andrea A1 Valente, Iacopo A1 D’argento, Francesco A1 Ferrante, Monica A1 Sala, Evis A1 Squillaci, Ettore YR 2024 UL http://jnis.bmj.com/content/16/Suppl_2/A122.2.abstract AB 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 metastasesMWA used alone or combined with other treatmentsReported pre- and post-MWA pain assessmentsPublished in EnglishData 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.