Percutaneous Radiofrequency Ablation for Painful Spinal Metastases Resulting in Resolution of Epidural Disease: A Case Report

Percutaneous image-guided ablation is used for treatment of both benign and malignant osseous lesions often leading to substantial pain relief and local tumor control. Paired with vertebral augmentation of the affected vertebra, patients can often become functional and experience significant pain reduction. However, bone ablation must be paired with various modalities of treatment as it only provides pain relief and local tumor control and does not address systemic metastatic disease. We describe a case of metastatic prostate cancer with epidural extension treated with percutaneous image-guided radiofrequency ablation and vertebral augmentation leading to substantial pain relief as well as resolution of the epidural disease as evidenced by short-term follow-up magnetic resonance imaging (MRI). To the best of our knowledge, the resolution of epidural disease has not been described before. This case highlights the potential of ablative therapy in metastatic bone disease, particularly in the presence of epidural disease.