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BackTable / MSK / Podcast / Episode #43
Cutting Edge Techniques in MSK Oncology: Cryoablation & Beyond
with Dr. Alan Alper Sag
In this BackTable MSK episode, host Dr. Jacob Fleming interviews interventional radiologist Dr. Alan Sag about techniques and advancements in bone cryoablation.
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BackTable, LLC (Producer). (2024, February 27). Ep. 43 – Cutting Edge Techniques in MSK Oncology: Cryoablation & Beyond [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Alan Sag
Dr. Alan Sag is a practicing intereventional radiologist at IR Centers in Miami, Florida.
Dr. Jacob Fleming
Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.
Synopsis
To start, Dr. Sag discusses his current practice and collaboration with orthopedic surgeons. He highlights IlluminOss, a new photodynamic bone stabilization system that uses similar concepts to endovascular balloons. Then, the doctors move onto discussing cryoablation, which was recently cleared by the FDA for use in pain palliation in bone metastases. Dr. Sag describes the procedural steps of cryoablation, pneumodissection with carbon dioxide, when to use polymethylmethacrylate (PMMA) augmentation, the value of same session biopsy, and education for referrers and patients.
Cryoneurolysis and intrathecal pain pumps are also discussed, as they can offer additional pain relief for patients and reduce opioid dependence.
Timestamps
00:00 - Introduction
03:20 - Collaboration with Orthopedic Surgery
08:57 - FDA Clearance for Cryoablation
14:47 - Cement Augmentation after Cryoablation
19:22 - Approach to the Cryoablation Procedure
26:57 - The Value of Same Session Biopsy
29:11 - Coordinating Cross-Specialty Oncologic Care
33:30 - Side Effects of Cryoablation
38:03 - Cryoneurolysis for Pain Reduction
45:40 - Skin Safety During Cryoablation
50:58 - Preferred Imaging Modalities
57:28 - Neuromodulation with Intrathecal Pain Pumps
Resources
Symposium on Clinical Interventional Oncology (CIO):
https://www.hmpglobalevents.com/cio
BackTable VI Ep. 221- Building a Musculoskeletal Oncology Service Line with Dr. Alan Sag:
https://www.backtable.com/shows/vi/podcasts/221/building-a-musculoskeletal-interventional-oncology-service
IlluminOss Photodynamic Bone Stabilization System:
https://www.illuminoss.com/eu
BackTable VI Ep. 401- The MOTION Study: Cryoablation for Painful Bony Metastases with Dr. Jack Jennings:
https://www.backtable.com/shows/vi/podcasts/401/the-motion-study-cryoablation-for-painful-bone-metastases
BackTable VI Ep. 284- Ortho/IR Collaboration in Private Practice with Dr. Tony Brown & Dr. Daniel Lerman:
https://www.backtable.com/shows/vi/podcasts/284/ortho-ir-collaboration-in-private-practice
BackTable MSK Ep. 25- Advanced Minimally Invasive Pain Interventions with Dr. David Prologo:
https://www.backtable.com/shows/msk/podcasts/25/advanced-minimally-invasive-pain-interventions
Pneumodissection for Skin Protection in Image-Guided Cryoablation of Superficial Musculoskeletal Tumors:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5499669/
BackTable MSK 40- Innovating Pain Management: The Role of Spinal Cord Stimulators in Outpatient Care with Dr. Doug Beall
https://www.backtable.com/shows/msk/podcasts/40/innovating-pain-management-the-role-of-spinal-cord-stimulators-in-outpatient-care
Bone cement: Serious adverse events, some with fatal outcome, associated with the use of bone cements for vertebroplasty, kyphoplasty and sacroplasty include myocardial infarction, cardiac arrest, cerebrovascular accident, pulmonary embolism and cardiac embolism. Although it is rare, some adverse events have been known to occur beyond one year post-operatively. Additional risks exist with the use of bone cement. Please see the IFU for a complete list of potential risks.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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