O29 Percutaneous radiofrequency ablation of painful spinal metastasis: an updated systematic review of analgesia and safety

<h3>Introduction</h3> Radiofrequency ablation(RFA) is a minimally invasive technique for managing pain from spinal metastases. However, long-term data on its effectiveness and safety remain limited. <h3>Aim of Study</h3> To systematically review the analgesic effectiveness and safety of RFA for spinal metastases. <h3>Methods</h3> A systematic search and analysis were conducted following PRISMA guidelines. Studies were included if they met the following criteria: Randomized or non-randomized studies with at least 3 patients (prospective or retrospective) Adult patients with spinal metastases RFA used alone or combined with other treatments Reported pre- and post-RFA pain assessments Published in English Data on demographics, tumor type, lesion location, pain scores, and complications were extracted. <h3>Results</h3> The search yielded 33 studies encompassing 1418 patients(52.6% females) with 1902 treated lesions. All studies reported achieving partial pain response based on International Consensus Endpoint after Radiation Therapy criteria. 91% of studies showed highly effective pain management(≥4-point reduction on a pain scale to the last follow-up). Moderate effectiveness(≥2-point reduction) was reported in the remaining 3 studies(9%). Lung(28.2%), breast(25.4%)and genitourinary system(11.2%) cancers were the most common primary tumors. The thoracic spine was the most frequent site(47.9), followed by lumbar(47.3%) and sacral(4.5%). No major complications(grade IV-V) were observed. Minor to grade IIIa neurological complications requiring conservative management occurred in 0-16% of patients. <h3>Conclusion</h3> This systematic review suggests that RFA, often used in combination with vertebral augmentation, represents a safe and effective treatment for achieving short- to mid-term (24 hours to 6 months) pain control in patients with spinal metastases. <h3>Disclosure of Interest</h3> no.