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Metastatic Spinal Tumors

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Lung, breast, and prostate cancers are the most common primary cancers that spread to the spine.

Lung cancer is the most common cancer to metastasize to the bone in men, and breast cancer is the most common in women. Other cancers that spread to the spine include multiple myeloma, lymphoma, melanoma, and sarcoma, as well as cancers of the gastrointestinal tract, kidney, and thyroid. Prompt diagnosis and identification of the primary malignancy are crucial to overall treatment. Many factors can affect the outcome, including the nature of primary cancer, the number of lesions, the presence of distant non-skeletal metastases and the presence and/or severity of spinal cord compression.

Tumors that involve the spine may cause intolerable pain by a number of different mechanisms. As the tumor grows within the vertebral body the pressure upon the endosteum increases and an inflammatory reaction of the periosteum ensues. At the tumor-bone interface, there is a release of chemical mediators that can cause pain and inflammation. As the tumor extends beyond the confines of the vertebral body, it can impinge upon exiting nerve roots causing radicular pain. While the tumor continues to grow and the vertebral body weakens, axial loading of the spine can result in pathologic compression fractures, resulting in pain.

How can Interventional Radiology Help?

Interventional Radiology (IR) is a unique medical specialty that provides non-surgical procedures guided by imaging (X-ray, CT-Scan, MRI, etc). In the case of metastatic osseous lesions to the spine, we can help with minimally invasive procedure allowing the physician, through small needle access to obtain a biopsy sample, destroy the tumor with ablation and treat the underlying pathologic compression fractures of the spine with vertebral augmentation techniques. The patient is usually discharged the same day. No surgical incision or stitches are needed.

Why Choose Us?

Pioneers of Spinal Tumor Radiofrequency Ablation Our specially trained physicians are among a few in the nation to pioneer this procedure using the STAR™ Tumor Ablation System and the OsteoCool™ RF Ablation system. Hundreds of patients have been treated successfully over the past 5 years at our institution even after exhausting or failing traditional therapies..

Expert care from highly trained interventional radiologists. Our interventional radiologists and radiology specialists are experts in a variety of minimally invasive procedures — everything from treatments to clear blocked blood vessels to advanced cancer therapies like NanoKnife®.

Leading-edge imaging care in South Florida. Our doctors are also researchers discovering new ways to improve diagnosis and treatment. That means you can get some of today’s most promising advancements through clinical trials. You benefit from the latest developments that are fast-tracked from the lab to the bedside.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Who is a Candidate? 


Any patient with focalized pain from a metastatic spinal tumor may be a candidate for Minimally invasive image-guided spine cancer ablation techniques, several specific patient groups will likely benefit most from the procedure.

Patients Who Benefit from Image-guided RF Spine Tumor Ablation Techniques

Patients with focal pain from metastatic spinal tumor(s) may be a candidate for treatment. However, patients that are ideally suited include those with:

  • Radio-resistant tumors
  • Persistent and/or recurrent pain after radiation therapy
  • Posterior vertebral body tumors
  • Reached maximum radiation dose limit
  • Focalized pain preventing immobilization for treatment with palliative radiation
  • Cannot undergo other palliative treatments due to their concurrent systemic treatments or ongoing clinical trials
  • Risk of myelosuppression


Treatments


Spinal Tumor Radiofrequency Ablation

For patients in severe pain from cancer that has metastasized to the spine from other locations, we are offering a revolutionary, minimally invasive, Image-guided non-surgical, pain-relieving procedure using spinal tumor radiofrequency ablation.

Rapid pain relief + localized tumor destruction
For localized pain, such as that associated with painful metastatic spinal lesions, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines for Adult Cancer Pain indicate that radiofrequency ablation should be a considered treatment option.

Fast & Durable
Oncologists and cancer care team members recognize the fast and durable pain relief patients achieve with minimally invasive targeted radiofrequency ablation (t-RFA) and vertebral augmentation.

Single Treatment
Minimally invasive image-guided spine cancer ablation techniques, delivers meaningful pain relief and localized tumor destruction in a single treatment, often in an outpatient setting. Usually, a small dressing or a Band-Aid is placed at the end of the procedure.

Control
Minimally invasive image-guided spine cancer ablation techniques provide physicians the control to create site-specific ablation zones and monitor real-time ablation zone development within the vertebral body.

Compatible
Spine RFA expands the range of treatment options for patients with painful metastatic spinal tumors as it is compatible with systemic therapies.

Vertebral Augmentation

These techniques can be used with RF ablation to treat the underlying pathologic compression fractures of the spine resulting from the bone destruction caused by cancer. Interventional Radiology physicians may use vertebroplasty, kyphoplasty or spine implants.

1. Kyphoplasty

Kyphoplasty is a minimally invasive procedure used to treat vertebral compression fractures of the spine. These painful fractures, which can limit mobility, are typically caused by osteoporosis, spinal tumors, or traumatic injury. During kyphoplasty, the Interventional Radiologist passes a hollow needle through the skin and into the fractured vertebra with the help of an imaging technology called fluoroscopy. The Interventional Radiologist inserts a balloon into the fracture, inflates it to expand the vertebra to its normal height, and then withdraws the balloon, leaving a space in the middle of the vertebra. The surgeon carefully injects bone cement, then withdraws the needle before the cement sets. The procedure, which is repeated for each affected vertebra, speeds recovery time and reduces the risk of future fractures.

2. Vertebroplasty

Vertebroplasty is a minimally invasive procedure used to treat vertebral compression fractures of the spine. These painful fractures, which can limit mobility, are typically caused by osteoporosis, spinal tumors, or traumatic injury. During vertebroplasty, the Interventional Radiologist passes a hollow needle through the skin and into the fractured vertebra with the help of an imaging technology called fluoroscopy. The Interventional Radiologist carefully injects bone cement into the fractured vertebra, restoring it to its normal height, and then withdraws the needle before the cement sets. The procedure, which is repeated for each affected vertebra, speeds recovery time and reduces the risk of future fractures.

3. The SpineJack® procedure

The SpineJack® system is indicated for use in the reduction of mobile spinal fractures that may result from osteoporosis, trauma fractures type A according to the Magerl classification and malignant lesions myeloma or osteolytic metastasis. The SpineJack® system can be used in combination with validated bone cement, and to be placed, using a transpedicular approach, through a vertebra pedicle with a minimum internal diameter, as verified with a pre-operative CT scan

4. The Kiva procedure

Patients with vertebral cracks, fractures, or collapses who don’t respond to conservative treatments such as bracing, bed rest, physical therapy, and pain management have a new surgical option: the Kiva VCF Treatment System. This system is similar to balloon kyphoplasty in that it is a vertebral augmentation procedure that treats the broken vertebra by creating an internal cast to restore the compressed vertebra to its normal size.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • Doctor's Healthcare Plan
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Community Care (FCC)
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care