Microwave ablation combined with percutaneous vertebroplasty in the treatment of spinal metastases:a meta-analysis of the efficacy and safety
YANG Zhen
WU Ming
CHEN Jian'gang
SONG Chao
ZHOU Jun
YANG Chen
ZHANG Yan
Abstract：Objective To systematically evaluate the efficacy and safety of microwave ablation(MWA)combined with percutaneous vertebroplasty(PVP)in the treatment of spinal metastases.Methods The PubMed,Embase,Co-chrane Library,Web of Science,CNKI,WanFang Data,CBM and VIP databases were searched for clinical studies on MWA combined with PVP in the treatment of spinal metastases.The search time limit was from the establishment of the da-tabase to April 2025.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.RevMan 5.4 software was used for Meta-analysis.Results Seven studies involving 451 patients were included.There were 236 patients in MWA combined with PVP group and 215 patients in PVP group.Meta-analysis results showed that:MWA combined with PVP demonstrated significantly superior outcomes compared to PVP alone in treating spinal metastases,especially in relieving the pain at 1 week after operation(MD=-0.29,95%CI:-0.43--0.15,P<0.01),1 month after operation(MD=-0.2,95%CI:-0.31--0.09,P<0.01)and 3 months(MD=-0.27,95%CI:-0.37--0.17,P<0.01),pain at 6 months after operation(MD=-0.48,95%CI:-0.66--0.31,P<0.01),in 6 month after operation ODI recovery(MD=-3.32,95%CI:-4.99--1.64,P<0.01),in reducing cement leakage rate(the num-ber of people:RR=0.24,95%CI:0.1-0.6,P<0.01;the number of vertebrae:RR=0.56,95%CI:0.33-0.97,P=0.04),and in reducing tumor recurrence rate(RR=0.34,95%CI:0.19-0.59,P<0.01).The operation cost of PVP group(MD=1.08,95%CI:1.07-1.08,P<0.01)was significantly lower than that of MWA combined PVP group.How-ever,there was no significant difference between MWA combined PVP group and PVP group in terms of early postoperative pain relief(the first day and the third day after surgery),ODI recovery(1 month and 3 months after surgery)and bone ce-ment injection volume.Conclusions Compared with PVP alone,MWA combined with PVP in the treatment of spinal metastases has certain advantages in long-term pain relief,ODI function recovery and reduction of tumor recurrence rate,and it is safe.However,the operation cost of MWA combined with PVP is higher,which may affect the treatment choice of patients.
Keywords：percutaneous vertebroplastymicrowave ablationspinal metastasesMeta-analysissystematic review
Publication Date：2025-08-25
Online Publishing Date：2025-09-10(First online date of this platform, not the publication date of the document)
Pages：6( 25-30 )