20982 Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency

Name of the Procedure:

Ablation Therapy for Reduction or Eradication of Bone Tumors (Radiofrequency Ablation, RFA)

Summary

Radiofrequency ablation (RFA) is a minimally invasive procedure that uses heat generated by radio waves to reduce or eradicate bone tumors. This technique can also be used to treat the adjacent soft tissue involved by tumor extension. The procedure is performed percutaneously (through the skin) with imaging guidance.

Purpose

RFA is used to address bone tumors, including metastatic bone disease. The goals of the procedure are to reduce pain, control local tumor growth, and improve the patient's quality of life.

Indications

• Painful bone tumors
• Bone tumors not amenable to surgical removal
• Adjacent soft tissue involvement by tumor extension
• Patients who are not candidates for surgery due to health constraints

Preparation

• Fasting for a specified period before the procedure (usually 6-8 hours)
• Discontinuation or adjustment of certain medications as advised by the physician
• Pre-procedure imaging tests (e.g., MRI, CT scans)
• Blood tests to assess general health and coagulation status

Procedure Description

1. The patient is positioned appropriately on the procedure table.
2. Local anesthesia or light sedation may be administered to ensure comfort.
3. Using imaging guidance (e.g., CT or ultrasound), the physician identifies the exact location of the tumor.
4. A thin needle or probe is inserted through the skin and directed to the tumor site.
5. Radiofrequency energy is delivered through the probe, generating heat that destroys the tumor cells.
6. The entire process is monitored via imaging to ensure precision.

Duration

The procedure typically takes about 1 to 2 hours, depending on the size and location of the tumor.

Setting

RFA is usually performed in a hospital or an outpatient surgical center equipped with imaging facilities.

Personnel

• Interventional Radiologist or specialized surgeon
• Radiology technician
• Nursing staff for patient care and monitoring
• Anesthesiologist or nurse anesthetist, if sedation is used

Risks and Complications

• Infection at the needle insertion site
• Bleeding or hematoma formation
• Thermal damage to surrounding tissues
• Nerve injury
• Incomplete ablation requiring additional treatment

Benefits

• Significant pain relief
• Minimal invasiveness compared to surgical options
• Quick recovery time
• Potential for preserved bone integrity and function

Recovery

• Patients are usually observed for several hours post-procedure
• Discharge with specific instructions for wound care and activity restrictions
• Pain management with prescribed medications
• Follow-up imaging to assess the efficacy of the treatment

Alternatives

• Surgical removal of the tumor
• Cryoablation (freezing the tumor)
• Radiation therapy
• Chemotherapy or targeted therapy
• Pros: May be considered more definitive for certain cases
• Cons: More invasive, longer recovery times, or potential side effects from systemic treatments

Patient Experience

During the procedure, the patient might feel mild discomfort due to needle insertion or manipulation. Post-procedure, some soreness at the insertion site is expected but managed with pain relief measures. Most patients can return to normal activities within a few days, following specific guidelines provided by their healthcare team.