Heat-Based STAR Ablation for Vertebral Tumors / Metastases at University Hospital Frankfurt

The Interventional Radiology Clinic at the University Hospital Frankfurt offers specialized, highly effective treatment for spinal tumors and metastases known as heat-based STAR ablation (spinal tumor ablation with radiofrequency). This advanced thermal therapy is specifically designed to treat painful or structurally threatening lesions within the vertebral bodies, particularly those originating from primary cancers such as breast, lung, or prostate. The provider integrates this cutting-edge radiofrequency technology with high-precision imaging to provide a minimally invasive alternative to traditional open surgery or as a complement to radiation therapy. The primary objective of the STAR ablation system is the targeted destruction of tumor tissue through controlled thermal energy. Unlike conventional radiofrequency ablation, the STAR system utilizes a unique, steerable bipolar electrode that allows the interventional radiologist to navigate precisely within the complex internal structure of the vertebra. This maneuverability is critical for reaching eccentrically located metastases while avoiding sensitive structures such as the spinal cord or nerve roots. Once the electrode is positioned within the tumor, radiofrequency energy is applied to generate localized heat, typically exceeding 60 to 70 degrees Celsius, which induces coagulative necrosis and immediate cell death of the malignant tissue. A significant advantage of the STAR ablation program at University Hospital Frankfurt is the frequent combination of heat-based destruction with cement augmentation, a procedure known as kyphoplasty or vertebroplasty. After the tumor mass has been thermally ablated, a cavity is often created, which is then filled with medical-grade bone cement (PMMA). This dual-action approach not only eliminates the tumor cells but also provides immediate mechanical stabilization of the weakened vertebra, significantly reducing the risk of pathological fractures and providing rapid relief from debilitating bone pain. The procedure is performed under continuous fluoroscopic or CT guidance using the Siemens ARTIS icono system, which ensures that heat distribution and cement application are monitored in real time with millimeter precision. The medical program begins with an intensive diagnostic phase where the patient's spinal stability and tumor burden are assessed through high-resolution MRI or CT imaging. Patients must provide current laboratory parameters, including coagulation status and kidney function markers, to ensure safety during the intervention. The actual vertebral metastases ablation is usually performed under deep sedation or general anesthesia to ensure patient comfort and complete immobility during the thermal application. Following the procedure, the patient is monitored in a specialized recovery area to manage the immediate post-operative phase and ensure the integrity of the puncture site. Clinical success is measured by a significant and rapid reduction in the patient's visual analog scale (VAS) pain scores and by improvement in overall mobility. By effectively debulking the tumor and stabilizing the bone in a single session, many patients experience a substantial increase in their quality of life and can often reduce their dependence on heavy opioid pain medications.