Percutaneous Radiofrequency Ablation of Osteoid Osteoma
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- Category: Vol. 81, March 2013
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Percutaneous Radiofrequency Ablation of Osteoid Osteoma,HAZEM M. MOHARRAM, AMR A. NASSEF, WALID A. EBEID and AHMED H. ABDELMAKSOUD
Abstract
Background: Osteoid osteoma is benign bone tumor that accounts for approximately 11% of all benign bone tumors. Pain is the hallmark of its clinical presentation, and is dramat-ically relieved by aspirin or non-steroidal anti-inflammatory drugs. Complete surgical resection has historically been the treatment of choice. En-bloc excision often requires a long incision, extensive dissection and, frequently, internal fixation. Minimally invasive therapies, such as percutaneous radiofre-quency (RF) ablation, have recently been developed. The use of RF ablation to treat osteoid osteoma was described to be safe, effective and avoids drawbacks of surgery.
Purpose: To report our experience in treating osteoid osteoma in different sites by RF ablation regarding the technical and clinical success, safety, complications, short and long-term follow-up.
Patients and Methods: Between November 2006 and June 2012, 120 patients underwent CT-guided percutaneous RF ablations for osteoid osteoma. Most of the lesions were located in the long bones, most commonly in the femur (n=74), followed by the tibia (n=31), humerus (n=6), 3 cases were in iliac bone, 3 in the lumbar vertebrae and 1 in the scapular glenoid, 1 in the acetabulum and 1 in the cervical spine. The patients did the procedures under spinal or general anesthesia using a 9mm exposed-tip probe radiofrequency probe Soloist Single Needle Electrode. Patients were followed-up at lweek, lmonth, and every 3 months thereafter in the first year and another visit after 2 years.
Results: The technical success rate was 100%. Within the follow-up period (6-24 month) 13 patient (10.8%) missed the follow-up visits; with the overall clinical success in the rest of the patients (89.2%) whom showed no pain recurrence. All patients had initial prompt pain relief and were able to return to their normal activities and discontinued analgesics. Two patients (1.6%) had recurrence of pain after 6 months and underwent repeat radiofrequency ablation. Two patients (1.6%) with a tibial shaft lesions developed superficial skin burn (epidermolysis), which responded well to conservative treat-ment.
Conclusion: We believe that percutaneous RFA is a safe and effective treatment for osteoid osteoma with significant advantages over surgery. It has a high clinical success rate and low incidence of complication.