{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T03:10:49Z","timestamp":1780715449341,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T00:00:00Z","timestamp":1713657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>There is still controversy over the choice of treatment for end\u2010stage spinal metastases. With the continuous development of microwave technology in spinal tumors, related studies have reported that microwave combined with techniques such as pedicle screw fixation and percutaneous vertebroplasty can achieve the purpose of tumor ablation, relieving spinal cord compression, enhancing spinal stability, effectively relieving pain, and reducing recurrence rates. This study aimed to analyze the effectiveness of microwave ablation combined with decompression and pedicle screw fixation in the palliative management of spinal metastases with pathological fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study enrolled 82 patients with spinal metastases and pathological fractures treated between January 2016 and July 2020, with 44 patients undergoing pedicle screw fixation along with laminectomy (fixation group) and the remaining 38 receiving microwave ablation in addition to the treatment provided to group fixation (MWA group). Before surgery, all patients underwent pain assessment using the visual analogue scale (VAS) and evaluation of spinal cord injury using the Frankel classification. After surgery, the patients' prognoses were assessed using the Tomita score, modified Tokuhashi score system, and progression\u2010free survival. Additionally, we compared operative time and blood loss between the two groups. Survival analysis utilized the Kaplan\u2013Meier method with a log\u2010rank test for group comparisons. Paired <jats:italic>t<\/jats:italic>\u2010tests and the Mann\u2013Whitney U test were applied to metric and non\u2010normally distributed data, respectively. Neurological function improvement across groups was evaluated using the \u03c7<jats:sup>2<\/jats:sup> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were followed up for a median duration of 18 and 20\u2009months in the fixation and MWA groups, respectively, with follow\u2010up periods ranging from 6 to 36\u2009months. Statistically significant reductions in postoperative VAS scores were observed in all patients compared with their preoperative scores. The MWA group exhibited reduced blood loss (<jats:italic>t<\/jats:italic>\u2009=\u20092.74, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), lower VAS scores at the 1\u2010 and 3\u2010month follow\u2010ups (<jats:italic>t<\/jats:italic>\u2009=\u20092.34, P\u2009=\u20090.02; <jats:italic>t<\/jats:italic>\u2009=\u20092.83, <jats:italic>p<\/jats:italic>\u2009=\u20090.006), and longer progression\u2010free survival than the fixation group (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Although the operation times in the MWA group were longer than those in the fixation group, this difference was not statistically significant (<jats:italic>t<\/jats:italic>\u2009=\u20096.06, <jats:italic>p<\/jats:italic>\u2009=\u20090.12). No statistically significant differences were found regarding improvements in spinal cord function between the two groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.77).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with decompression and pedicle screw fixation for treating spinal metastases with pathological fractures, microwave ablation combined with decompression and pedicle screw fixation showed better outcomes in terms of pain control, longer progression\u2010free survival, and lower blood loss without increasing operative time, which has favorable implications for clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14063","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T03:15:21Z","timestamp":1713755721000},"page":"1292-1299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Analysis of Microwave Ablation Combined 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawei","family":"Gou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics People's Fourth Hospital of Sichuan Province  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunfu","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics People's Fourth Hospital of Sichuan Province  Chengdu 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