Evaluation of the therapeutic efficacy of precise microwave ablation combined with spinal tumor separation surgery for managing spinal metastases

Background Spinal metastases represent a significant clinical challenge, often resulting in severe pain, neurological dysfunction, and reduced quality of life. While surgical intervention remains a primary treatment modality, the optimal surgical approach continues to be debated. This study aims to evaluate the clinical efficacy of precise microwave ablation (MWA) combined with spinal tumor separation surgery compared to tumor separation surgery alone in treating thoracolumbar metastases. Methods A retrospective analysis was conducted on 83 patients with thoracolumbar metastases who underwent surgery at the General Hospital of the Chinese People's Liberation Army between January 2020 and December 2022. Patients were divided into two groups: the study group (n = 34) received precise MWA combined with spinal tumor separation surgery, while the control group (n = 49) underwent tumor separation surgery alone. Clinical outcomes assessed included operative time, intraoperative blood loss, visual analog scale (VAS) scores, Frankel neurological grading, complications, and overall survival. Follow-up ranged from 6 to 28 months. Results No significant differences were observed in preoperative Tomita scores, modified Tokuhashi scores, spinal instability neoplastic scores (SINS), or Frankel scores between groups (P > 0.05). The study group demonstrated significantly reduced intraoperative blood loss (956.91 ± 150.02 ml vs. 1482.52 ± 110.01 ml, P < 0.001) and shorter operative time (279.61 ± 32.01 min vs. 306.03 ± 28.04 min, P < 0.001) compared to the control group. At 1-month postoperatively, the study group showed significantly lower VAS scores (1.72 ± 1.01 vs. 2.41 ± 0.77, P = 0.0013). Neurological function improvement rates were comparable between groups (94% vs. 91%, P = 0.69), as were complication rates (2.9% vs. 4.1%, P = 0.79). No significant difference in overall survival was observed between groups (P > 0.05). Conclusions The combination of precise microwave ablation with spinal tumor separation surgery offers significant advantages in treating spinal metastases, including reduced surgical trauma, decreased intraoperative bleeding, and enhanced short-term pain relief. This approach represents an effective and safe adjunctive treatment modality that improves patient quality of life without increasing surgical risks. Trial Registration Not applicable.