RF-TVA

Radiofrequency targeted vertebral augmentation (also written as RF-TVA) is a form of kyphoplasty that uses radiofrequency heat to control the viscosity of bone cement and deliver it into the vertebral body to treat vertebral compression fractures.

Indications

The DFINE RF-TVA product is used to treat pathological fractures of the vertebral body due to osteoporosis, cancer, or benign lesions. Cancer includes multiple myeloma and metastatic lesions, including those arising from breast or lung cancer, or lymphoma. Benign lesions include hemangioma and giant cell tumor.

Details

RF-TVA was first developed by DFINE, Inc., a medical device company based in San Jose, California. Its product, the StabiliT Vertebral Augmentation System received clearance from the United States Food and Drug Administration in 2008 and is CE marked for commercial sale in Europe.

Procedure

During the days before surgery, a doctor may recommend that a person avoids taking drugs that make it hard for blood to clot, such as aspirin and warfarin. On the day of surgery, a person will probably be told not to eat or drink anything for several hours before the procedure. A person can take any medication a doctor approves, along with sips of water.

A surgeon will perform RF-TVA in a hospital or outpatient clinic. A person may have either local or general anesthetic. The surgical procedure is as follows:

Radiofrequency targeted vertebral augmentation is a minimally invasive procedure designed to preserve good bone while performing vertebral augmentation (sometimes referred to as kyphoplasty). With traditional kyphoplasty, a balloon is used to create a space within the cancellous bone and then cement is injected into the space. The RF-TVA procedure is different in that a physician directs a small navigational canula into the vertebra and creates a small pathways for the cement as opposed to using a balloon. This process preserves more of the healthy canncellous bone. The pathways are then filled with ultra-high viscosity bone cement which then permeates into the surrounding bone, stabilizing the fracture and restoring vertebral height. Most people will be able to go home from the hospital the same day. A person should not drive unless a medical professional approves it.

Risks and complications

Risks and complications of kyphoplasty may include:

  • Infection
  • Increased back pain
  • Bleeding
  • Nerve damage
  • Allergic reaction to the chemicals used with X-rays to help guide the surgeon
  • Acrylic bone cement leaking out of position

Although risks related to RF-TVA are rare, serious complications can occur, including spinal cord compression, nerve root compression, venous embolism, and pulmonary embolism, including cardiovascular collapse. According to the American Association of Neurological Surgeons, Kyphoplasty or related procedural complication rates are at less than 2% for osteoporotic VCF’s, and up to 10% for malignant tumor-related VCF’s.

Credits & Sources:

  1. MedlinePlus
  2. MedicalNewsToday
  3. Dalton, BE; AC Kohm; LE Miller; JE Block; RD Poser (19 November 2012). “Radiogrequency-targeted vertebral augmentation versus traditional balloon kyphoplasty”. Clinical Interventions in Aging. 7: 525–531. doi:10.2147/CIA.S37025. PMC 3508556. PMID 23204845.
  4. Moser, Franklin G.; Marcel M Maya; Laura Blaszkiewicz; Andrea Scicli; Larry E Miller; Jon E. Block (20 October 2013). “Prospective Single-Site Experience with Radiofrequency-Targeted Vertebral Augmentation for Osteoporotic Vertebral Compression Fracture”. Journal of Osteoporosis. 2013: 791397. doi:10.1155/2013/791397. PMC 3817678. PMID 24228187.
  5. Robertson, Scott C. (2011). Percutaneous Vertebral Augmentation: StabilitiT A New Delivery System for Vertebral Fractures. Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves. Acta Neurochirurgica Supplementum. 108. pp. 191–195. doi:10.1007/978-3-211-99370-5_29. ISBN 978-3-211-99369-9. PMID 21107958.
  6. Erdem, Eren; Sertack Akdol; Adewumi Amole; Katy Fryar; Robert W. Eberle (1 July 2013). “Radiofrequency-Targeted Vertebral Augmentation for the Treatment of Vertebral Compression Fractures as a Result of Multiple Myeloma”. Spine Journal. 38 (15): 1275–1281. doi:10.1097/BRS.0b013e3182959695. PMID 23591655.
  7. Chandler, Michele (15 August 2010). “DFine Inc. cements future in vertebrae surgical market”. San Jose Business Journal. Retrieved 5 May 2014.

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