Combined use of SpineJack and microwave ablation with CT and C-arm in the treatment of vertebral fractures in oncologic patients: a case- based technical note.

This technical report highlights the combined treatment of bone metastasis using CT imaging and C-arm fluoroscopy to guide microwave thermal ablation and the SpineJack system. The integration of these imaging techniques was crucial for achieving local tumor control and restoring vertebral stability in cases of pathological fractures associated with metastatic disease. CT imaging ensured accurate tumor volume measurement and ablation, safe needle placement, and secure positioning of protective devices, while C-arm fluoroscopy provided real-time guidance for the correct positioning of the SpineJack implants, monitoring their expansion, and ensuring controlled cement application. Although the combination of these techniques has been increasingly utilized, this is the first detailed report to focus on their combined use in treating pathological fractures within a metastatic setting.