Interstitial laser photocoagulation for the treatment of osteoid osteoma

Witt, Johan; Hall-Craggs, MA; Ripley, Paul M.; Cobb, Justin P.; Bown, SG

doi:10.1302/0301-620x.82b8.0821125

Cited by 30 publications

(13 citation statements)

References 14 publications

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“…Several CT-guided percutaneous techniques have been employed to achieve removal or destruction of the nidus with minimal invasiveness, including thermal destruction by means of laser photocoagulation or RFA. [57][58][59][60][61][62][63][64][65] The hip is the most common location of intra-articular osteoid osteomas. They are usually located at the femoral neck and less commonly at the femoral head or the acetabulum.…”

Section: Materials and Techniquementioning

confidence: 99%

“…57,65 The technique consists of percutaneous insertion of optical fibres into the tumour using a continuouswave semi-conductor portable diode laser connected to a fibre with a bare tip. It induces direct cellular heating and coagulative necrosis.…”

Section: Ct-guided Laser Interstitial Thermal Therapymentioning

confidence: 99%

“…It induces direct cellular heating and coagulative necrosis. 57 The procedure is performed under CT guidance and under general anaesthesia. The fibre is placed in a similar manner as RF probes.…”

Section: Ct-guided Laser Interstitial Thermal Therapymentioning

confidence: 99%

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Interventional MSK procedures: the hip

Dodré¹,

Lefebvre²,

Cockenpot³

et al. 2016

BJR

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Percutaneous musculoskeletal procedures are widely accepted as low invasive, highly effective, efficient and safe methods in a vast amount of hip pathologies either in diagnostic or in therapeutic management. Hip intra-articular injections are used for the symptomatic treatment of osteoarthritis. Peritendinous or intrabursal corticosteroid injections can be used for the symptomatic treatment of greater trochanteric pain syndrome and anterior iliopsoas impingement. In past decades, the role of interventional radiology has rapidly increased in metastatic disease, thanks to the development of many ablative techniques. Image-guided percutaneous ablation of skeletal metastases provides a minimally invasive treatment option that appears to be a safe and effective palliative treatment for localized painful lytic lesion. Methods of tumour destruction based on temperature, such as radiofrequency ablation (RFA) and cryotherapy, are performed for the management of musculoskeletal metastases. MR-guided focused ultrasound surgery provides a non-invasive alternative to these ablative methods. Cementoplasty is now widely used for pain management and consolidation of acetabular metastases and can be combined with RFA. RFA is also used to treat benign tumours, namely osteoid osteomas. New interventional procedures such as percutaneous screw fixation are also proposed to treat non-displaced or minimally displaced acetabular roof fractures. INTRODUCTIONHip intra-articular injections have been used for many years as a diagnostic and/or therapeutic tool and even today remain an effective treatment for osteoarthritis providing pain relief. Ultrasound guidance can be used for injections in patients with greater trochanteric pain syndrome and CT scan guidance for corticosteroid injection in the management of anterior iliopsoas impingement after total hip arthroplasty. Interventional radiology plays a major role in the management of bone tumours. Several image-guided percutaneous ablation methods have proved effective for palliation of metastases involving bone and for the treatment of benign bone tumours, namely osteoid osteoma. To treat pain and consolidate the bone, cementoplasty could be required. In the therapeutic management of acetabular fractures, the combination of CT and fluoroscopy guidance could have a place in treating non-displaced or minimally displaced acetabular roof fractures.

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Section: Materials and Techniquementioning

confidence: 99%

Section: Ct-guided Laser Interstitial Thermal Therapymentioning

confidence: 99%

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Interventional MSK procedures: the hip

Dodré¹,

Lefebvre²,

Cockenpot³

et al. 2016

BJR

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“…The laser induces direct cellular heating and thermo coagulation of the tissue. This technique is relatively costly and has a higher complication rate than radio-frequency ablation (RFA) (23,24).…”

Section: Introductionmentioning

confidence: 99%

Femur shaft fracture following osteoid osteoma radiofrequency ablation

Mazzawi

Militianu

Eidelman

et al. 2017

ccmbm

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SummaryIntroduction. Radiofrequency ablation is an effective modality in treating osteoid osteoma while avoiding the complications of an open procedure. Its complications are usually self-limited consisting mostly of local skin burns. This report presents a major complication, a femur shaft fracture following an osteoid osteoma radiofrequency ablation. The fracture occurred approximately one year after the ablation at the site of the osteoid osteoma. Discussion. Few case reports have been published regarding subtrochanteric femur fracture after ablation of an osteoid osteoma. To our knowledge this is the first report of a femoral shaft fracture following an ablation. Another unique characteristic of the presented case is the late presentation, approximately one year following ablation. Factors which may have contributed to the fracture include lateral entry point of the drill which may have weakened the femur when taking its biological and mechanical properties into account, and the fact that the patient was a soldier who was allowed to continue his military training only six weeks after the ablation. Conclusion. Radiofrequency ablation is an effective and relatively safe technique in treating osteoid osteomas, however the physician should be aware of the fracture risk involved, consider mechanical and biologic factors of the bone prior to drilling, and be very conservative when recommending return to high level activity. In addition, a close follow-up should be carried on after the procedure in order to supervise bone remodeling.

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“…Heating energy can be generated by microwaves, RF, high-intensity US or laser. 3,4 Thermal ablation also includes cryotherapy, in which tumour necrosis is achieved by freezing to below -20ºC. 5 Image-guided RF thermal ablation (RFTA) is a branch of interventional oncology that uses direct application of RF-generated heat to coagulate and destroy tumour tissue.…”

mentioning

confidence: 99%