Affiliations: [a] Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany | [b] Department of Orthopedics, Medical Center City Aachen GmbH, Wuerselen, Germany | [c] Centre for Orthopaedics, University Medical Centre, Halle (Saale), Germany
Correspondence:
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Corresponding author: L. Westermann, Centre for Orthopaedic and Trauma Surgery, University Medical Centre, Cologne, Germany. E-mail:[email protected]
Abstract: INTRODUCTION: Due to spinal instability and compressive neurologic
deficits surgical management is sometimes necessary in patients with
metastatic spinal lesions. However, in some cases open surgery is not
possible and minimally invasive procedures, like cryoablation, are needed.
The aim of the current study was to investigate whether a miniature
cryoprobe provides adequate tissue cooling in vertebrae and to evaluate the
direct impact of cryosurgery on vertebral body stability.
MATERIALS AND METHODS: Twelve thoracic vertebral bodies were
harvested from fresh cadavers. After documenting bone density cryoablation
was performed in six vertebral bodies according to a standardized procedure.
Afterwards temperature inside the vertebral body and maximum breaking force
were measured in the control and experimental groups.
RESULTS: Required temperature of -50° was reached in all areas.
There was a significant correlation between maximum breaking force and
measured bone density (p= 0.001). Mean breaking force within the experimental
group was 5047 N (SD = 2955 N) compared to 4458 N (SD = 2554 N) in the control
group. There were no observable differences in maximum breaking force
between both groups.
CONCLUSION: Miniature cryoprobe can deliver adequate tissue cooling
to -50°C in vertebral bodies. The procedure does not seem to influence
breaking force of the treated bones in-vitro. Therefore, using miniature
probes cryosurgery may provide a valuable alternative to conventional
surgical resection of neoplastic diseases as well as of benign locally
aggressive bone tumors.
Keywords: Cryoablation, miniature cryoprobes, metastatic spinal lesion, breaking force
