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BackTable / MSK / Podcast / Episode #33

New Frontiers in Spinal Tumor Ablation & Augmentation

with Dr. Dana Dunleavy

In this episode, host Dr. Jacob Fleming interviews Dr. Dana Dunleavy about spinal tumor ablation and vertebral augmentation. Dana is an interventional radiologist and Director of Windsong Interventional & Vascular Services.

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New Frontiers in Spinal Tumor Ablation & Augmentation with Dr. Dana Dunleavy on the BackTable MSK Podcast)
Ep 33 New Frontiers in Spinal Tumor Ablation & Augmentation with Dr. Dana Dunleavy
00:00 / 01:04

BackTable, LLC (Producer). (2023, October 18). Ep. 33 – New Frontiers in Spinal Tumor Ablation & Augmentation [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Dana Dunleavy discusses New Frontiers in Spinal Tumor Ablation & Augmentation on the BackTable 33 Podcast

Dr. Dana Dunleavy

Dr. Dana Dunleavy is a musculoskeletal and vascular IR in Buffalo, New York.

Dr. Jacob Fleming discusses New Frontiers in Spinal Tumor Ablation & Augmentation on the BackTable 33 Podcast

Dr. Jacob Fleming

Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.

Show Notes

Dana begins the discussion by reflecting on his upbringing in a small country town. His parents, his mother a midwife and his father a contractor, shaped his early experiences. His exposure to medicine began through his mother, particularly in witnessing childbirths. As he navigated his way through medical school, he contemplated various specialties, including orthopedic surgery, interventional radiology, and neurosurgery. He discovered incredible mentors in radiology and ultimately found his place in the field of interventional radiology. During his residency at Johns Hopkins, he sought externships in interventional spine and had the opportunity to immerse himself in this field for one month.

He underscores the significance of participating in tumor boards and being a valuable contributor to the team in terms of diagnosis and treatment. He also emphasizes the value of calling consults when performing biopsies and the importance of meeting with the patient face-to-face and engaging in a thorough discussion of the treatment plan.

Next, Dana delves deeper into the topics of bone tumor ablation and mechanical augmentation. He notes the importance of having a comprehensive understanding of the patient's anatomy and being well-versed in interventional tools. Cement extravasation is a feared complication of vertebral augmentation, so Dana discusses the role of implants as a means to establish structural support and mitigate the risk of cement leakage. In addition, he talks about his approach in combining ablation with mechanical augmentation so that the augmentation provides a structure after the ablation.

Lastly, he discusses the use of advanced technology such as cone beam CT in trajectory planning. He shares his hybrid approach to performing bone biopsies, utilizing fluoroscopy during access and cone beam CT to ascertain accurate trajectory.

Transcript Preview

[Dr. Dana Dunleavy]
Trajectory planning doesn't really work here. Sometimes the angles that we choose, the machine will just tell you, not achievable, can't do it. You still couldn't access, which we did under fluoroscopic guidance and you still could visualize it with Cone Beam CT, but we did have to utilize those things we talked about before where we said we're almost in the right place, but I just have to use tactile feel to move myself 5 millimeters more caudal and more medial and then we were perfect. Nobody wants to hear that you were okay, not terrible. We were really happy to be perfect after using that combination of knowledge and tactile feel.

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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