t-RFA, L4 Metastatic Lesion

Pre-op CT Axial

Pre-op CT axial image of L4 with a destructive, posterior vertebral body lesion. Pre-op CT images used to plan access, size, and shape of desired ablation zone.

Instrument Placement

The Working Cannula of the coaxial STAR™ System was docked at anterior aspect of right pedicle. Articulation of the SpineSTAR instrument allows navigation to center of the metastatic lesion in posterior aspect of vertebra. The SpineSTAR®’s insulator, identified as the radiolucent region area near distal end of the instrument, represents center of ablation zone.

Procedure

Ablation was performed at power level 1 (5W) until the distal thermocouple registered 50ºC, representing the predetermined desired ablation zone of ~20 mm long by ~14 mm wide. Total ablation time was 2:30 minutes. Patient reported post procedure pain relief. No complications or thermal injury occurred.

One Month Post Procedure

MRI images demonstrated the lesion was included within a discrete ablation zone.

One Month Post Procedure

MRI images demonstrated the shape of ablation zone consistent with the expected 3:2 length/width aspect ratio. Temperature displayed on MetaSTAR® Generator during ablation permitted real-time monitoring of ablation zone size based location of the SpineSTAR thermacouples in the vertebral body.

One Month Post Procedure

Post-contrast T1 images demonstrating ablation zone (thin arrows) and necrosis of lesion with minimal enhancement posteriorly.

t-RFA, L5 Metastatic Lesion

Pre-op CT Axial

Pre-op CT axial image of L5 vertebra with a destructive, posterior vertebral body lesion. Pre-op CT images used to plan access, size, and shape of desired ablation zone. Two adjacent ablations were planned to ensure coverage of the entire lesion.

Instrument Placement

Transpedicular intra-op navigation of SpineSTAR® instrument performed under flouroscopic guidance to position across midline in the posterior aspect of the L5 vertebra for first of two ablations.

Procedure

Two ablations were performed during which the SpineSTAR was articulated to adjacent areas. Patient reported post procedure pain relief. No complications or thermal injury occurred.

One Month Post Procedure

One month post procedure: MRI demonstrates clearly demarcated ablation zones in L5. The periphery of the ablation zones are again identified by the reactive zone at the periphery of the two overlapping zones. The combination of targeted ablation zone and navigation permits larger areas to be treated.

One Month Post Procedure

Contrast MRI confirms distinct ablation zone / necrosis of lesion with minimal enhancement posteriorly in L5.