Mini-open excision of osteoid osteoma using intraoperative O-arm/Stealth navigation

Abstract

Background: Although osteoid osteomas have traditionally been treated by surgical excision, radiofrequency ablation (RFA) has gained favor as a less invasive procedure. However, RFA is contraindicated for osteoid osteomas close to the skin or crucial neurovascular structures, and is not covered by national health insurance in Japan. The aim of the present study was to evaluate the efficacy of surgical excision of osteoid osteomas using intraoperative navigation. Methods: We performed a retrospective review of five patients with osteoid osteoma who underwent a mini-open excision using O-arm/Stealth navigation at our institution. The osteoid osteomas were excised using a cannulated cutter or curetted out with the assistance of navigation. Results: Complete excision was achieved in all patients, which was confirmed by pathological examination. The mean skin incision was 2.1 cm (range, 1.5 to 3.0 cm) and the mean duration required for setup three-dimensional image was 15 min (range, 12 to 20 min). Although the mean visual analog scale score was 7 (range, 4 to 8) before surgery, all patients experienced relief from their characteristic pain immediately after surgery, with the mean scores of 2.2 (range, 1 to 3) and 0 at 2 days and 4 weeks after surgery, respectively. There was no intra-operative complication related to the navigation and no recurrence was observed during the mean follow-up period of 25 months (range, 13 to 33 months). Conclusions: Mini-open excision using intraoperative O-arm/Stealth navigation is a safe and accurate procedure for patients with osteoid osteoma, which could cover the limitation of RFA.

Intraoperative three-dimensional navigation for surgical treatment of osteoid osteoma in the upper extremity: A series of 19 cases

“…It also allowed operation room and surgical team setting which enables an open or mini open approach with dissection and protection of neurovascular structures. The navigated technique for the treatment of osteoid osteoma has been described in several publications in addition to ours, 15,19,23–25 and this is the first that is specific to the upper extremity. In a study by Ankory et al, our surgical technique was first described and published.…”

O-Arm-Navigated, Robot-Assisted Versus Conventional CT Guided Radiofrequency Ablation in Treatment of Osteoid Osteoma: A Retrospective Cohort Study

“…Some studies also highlighted the importance of minimizing radiation exposure in the adolescent population ( 22 , 23 ). Nowadays, more attention is being paid to robot-assisted surgery and 3D navigation for their great potential in clinical application ( 24 ). Compared with the CT scan, O-arm can decrease the radiation exposure to both surgical staff and patients ( 25 , 26 ).…”

Osteoid Osteoma: An Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological Features, and Treatment Option

“…Intraoperative localization and identification of the nidus guided by CT or 99mTc have been reported (6). Additionally, intraoperative radiographic guidance through 2-D navigation with the C-arm and recently with 3-D navigation with the Oarm has been also described (71,72).…”