Cryoablation of Osseous Metastatic Disease
Modern cryosurgery had its beginnings in the 1960s. Marcove is credited with introducing this technique to the field of orthopedic oncology in 1968 (1). Since then, it has gained widespread use as adjuvant therapy for ablation of the tumor margins in the treatment of both benign and malignant tumors with intralesional curettage (2-21). Most of this work is done with what is referred to as an open system, with direct application of the cryomaterial to the tumor surface. With the advent of closed systems, utilizing probes through which the cryogen is delivered, the applications of cryoablation have grown (22). Cryoablation has been long employed in the field of dermatology, and the past decade has seen its principles being applied to the treatment of urologic, hepatic, lung and breast tumors, and even in treatment of cardiac conditions. More recently, percutaneous cryoablation systems have been utilized in the treatment of selected primary bone tumors and metastases. Although early in the experience, preliminary reports have been encouraging (23,24).