ABSTRACT

In the past three decades, many investigators have applied thermally mediated ablative procedures for the treatment of musculoskeletal neoplasms. Much of this preliminary work has been performed in animal models and small, limited clinical studies. These studies have shown the techniques of cryosurgery and radiofrequency (RF) to have some utility in specific clinical situations and specific tumors. To date, the most widely utilized techniques are cryosurgery in the operative setting of malignant or locally recurrent neoplasms such as giant cell tumor and percutaneous RF ablation (RFA) of osteoid osteomas and osseous metastatic disease using computed tomographic (CT) guidance. This chapter will give a brief overview of the problem of osseous metastatic disease, discuss the principles of RFA, and explain how I have applied the new minimally invasive technique of percutaneous CT-guided RFA as a treatment option for this group of patients.