Support: National Institutes of Health (NIH) SBIR grant
Principle Investigator: D.M. Sciubba
Primary and metastatic bone cancer and multiple myeloma affects over 600,000 people every year in the United States and cause progressive bone destruction that results in severe pain, fractures, and the inability to walk. Metastatic lesions are the most common tumors of the spine, but hematologic malignancies, such as multiple myeloma and lymphoma may also frequently involve multiple vertebral levels. Given improvements in treatments for systemic malignancies leading to longer overall survival, the incidence of metastatic lesions appearing in the spine will continue to increase. Patients usually present with incapacitating pain secondary to bony involvement, with or without vertebral collapse, and to spinal cord and/or nerve roots compression, commonly leading to paraplegia and quadriplegia.
Surgical options are not possible for all patients, but when indicated, they consist often of heavy interventions such as corpectomy or cage placement, with significant postprocedural recovery periods and high morbidity and mortality rates in patients who often have limited life expectancies. In addition, multifocal vertebral lesions are common and may contraindicate surgery. All facts considered current options for local treatment of metastatic spine cancer are largely insufficient.
Under CAT scan guidance we have successfully inserted needles into the spine tumors of rabbits using a minimally invasive technique. Through this needle it is possible to insert an ablator that emits ultrasound energy sufficient to increase the temperature of the tissue and kill tumor cells. The ability to conform the energy to the shape of the tumor with a sharply defined fringe field is critical and may provide significant tumor treatment without injuring the spinal cord or nerve roots. We are currently attempting to test this technique on pigs and hope to begin our human trial relatively soon.
Borrowed from: Sciubba DM, Burdette EC, Cheng JJ, Pennant WA,
Noggle JC, Petteys RJ, Alix C, Diederich CJ, Ficthinger G, Gokaslan ZL,
Murphy KP. Percutaneous Computed Tomography-guided conformal
ultrasonic ablation of vertebral tumors using a rabbit tumor model.
Laboratory investigation. J Neurosurg Spine. 2010 Dec;13(6):773-9