[Translated article] Tumor ablation and vertebral augmentation in the treatment of vertebral metastases: A multicenter study.

INTRODUCTION: Treatment of metastatic vertebral fractures without neural compression is performed with percutaneous cementation techniques. The increase in intratumoral pressure by these techniques can send tumor cells into the bloodstream. To prevent this dissemination and improve pain treatment, ablation techniques have been introduced that would allow the creation of a cavity in the tumor prior to cementation or directly necrosing the metastasis when its size is small. MATERIAL: We present the experience with ablation of two hospitals and two different ablation techniques. The first group used radiofrequency ablation (A) in 14 patients (26 vertebrae), 4 of whom underwent vertebral arthrodesis. The second group used microwave ablation (B) in 93 patients (129 lesions) without associated vertebral instrumentation. RESULTS: In group A pain improvement in VAS was 7.7-2.6 at 6 weeks. There were no complications derived from the ablation. In most cases cementation was associated. In the group B pain improvement in VAS went from 6.8 to 1.7 at 6 weeks. Cementation was associated in all cases. There were no complications derived from the ablation. CONCLUSION: The association of ablation techniques with vertebral cementation is a safe technique that significantly improves the patient's pain and can help control the disease.

Tumor ablation and vertebral augmentation in the treatment of vertebral metastases: A multicenter study. / Ablación tumoral y cementación en el tratamiento de las metástasis vertebrales. Estudio multicéntrico.

INTRODUCTION: Treatment of metastatic vertebral fractures without neural compression is performed with percutaneous cementation techniques. The increase in intratumoral pressure by these techniques can send tumor cells into the bloodstream. To prevent this dissemination and improve pain treatment, ablation techniques have been introduced that would allow the creation of a cavity in the tumor prior to cementation or directly necrosing the metastasis when its size is small. MATERIAL: We present the experience with ablation of two hospitals and two different ablation techniques. The first group used radiofrequency ablation (A) in 14 patients (26 vertebrae), 4 of whom underwent vertebral arthrodesis. The second group used microwave ablation (B) in 93 patients (129 lesions) without associated vertebral instrumentation. RESULTS: In group A pain improvement in VAS was 7.7-2.6 at 6 weeks. There were no complications derived from the ablation. In most cases cementation was associated. In the group B pain improvement in VAS went from 6.8-1.7 at 6 weeks. Cementation was associated in all cases. There were no complications derived from the ablation. CONCLUSION: The association of ablation techniques with vertebral cementation is a safe technique that significantly improves the patient's pain and can help control the disease.

[Biatrial thrombosis]. / Trombosis biauricular.

A fifty-eight year old patient presented subacute right heart failure. Transthoracic and transesophageal echocardiography revealed thrombi in both atria, and initial anticoagulation and subsequent surgical treatment were successful. Echocardiography is defined as being decisive to diagnosis, and the role of surgery in the treatment of these patients is commented.

Discitis due to Clostridium perfringens.

Diagnosis of the infectious process of the intervertebral disc is often delayed due to the lack of specifity of the clinical picture. This delay in diagnosis and consequently in treatment can lead to severe neurologic sequela. In these cases, punction biopsy of the intervertebral disc is of special value. The authors found no mention in the literature concerning Chlostridium perfringens discitis verified by aspiration and fluid culture extracted by intervertebral disc puncture.