Many tumour patients develop painful vertebral metastases in the course of their disease that destroy the vertebrae and often do not adequately respond to standard therapies. We reviewed current evidence on efficacy and safety of radiofrequency ablation (RFA), a minimally invasive procedure, in patients with painful vertebral metastases.

Four prospective and five retrospective single-arm studies were evaluated. Overall, the level of evidence for efficacy is not estimable and "very low" for safety outcomes. The current evidence suggests that RFA leads to a significant pain reduction and an improvement in health-related quality of life. Furthermore, no major complications occurred for the use of RFA. However, the studies have several limitations.

Therefore, we recommend the inclusion of RFA in the Austrian BMGF catalogue of procedures with restrictions and suggest a re-evaluation after 2021.