How do you manage debilitating pain in spine oncology patients when opioids alone aren’t enough and surgical decompression isn’t immediately feasible? This discussion tackles the convergence of multiple pain management strategies—from strategic radiation dosing to nerve blocks and cryoablation—revealing how each modality plays a distinct role in comprehensive care. Discover the cutting-edge debate around ablating pain-generating nerves in non-ambulatory patients: cryoablation offers temporary relief with axonal regrowth in 3-4 months, potentially bridging patients to mobility and systemic therapy, but raises critical questions about motor versus sensory preservation. Learn the radiation dose thresholds that provide analgesia without causing permanent nerve injury, and why timing these interventions correctly within the treatment sequence can mean the difference between managing symptoms and achieving functional recovery.
Contributors:
Dr. Mark Amsbaugh is the Director of Radiation Oncology at Texas Medical Center in Houston, Texas.
Dr. Ran Lador is an orthopedic spinal surgeon practicing at Memorial Hermann Health System in Houston, Texas.
Dr. Alexa Levey is an interventional radiologist, interventional pain proceduralist, and assistant clinical professor in Houston, Texas.
