Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation

Martel, José; Bueno, Ángel; Nieto-Morales, Ma Luisa; Ortiz, Eduardo J.

doi:10.1016/j.ejrad.2008.04.020

Cited by 54 publications

(33 citation statements)

References 19 publications

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“…The monopolar system like the one used in our study is more widely used for this application, in which a single electrode is introduced inside the lesion and grounding pads are placed on the patient skin to complete the electrical cycle. 17 In the bipolar system, two electrodes are inserted inside the lesion, one for energy deposition and the other is the retuning electrode. 18 Early reports in the literature described some technical limitations including inability to access the nidus as the fluoroscopy alone rather than CT was the imaging modality available to localise the lesion.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Al-Omari¹,

Ata

Al-Muqbel³

et al. 2012

J Med Imag Rad Onc

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Introduction: The aim of this study is to assess the safety and the efficacy of radiofrequency ablation (RFA) of osteoid osteoma with Soloist monopolar electrode using tissue impedance, rather than temperature, as an indicator of osteonecrosis. Methods: The medical records and imaging studies of 30 patients (males 18, females 12) who underwent RFA of osteoid osteoma at our institution were reviewed. The mean age of the patients was 15.3 years (range 5-34 years) and the mean duration of follow up was 26.9 months (range 3-52 months). The lesions were located in the femur (n = 6, 53%), tibia (n = 8, 27%), hand (n = 3, 10%), foot (n = 2, 6%) and humerus (n = 1, 3%). The procedure was performed with general anaesthesia under CT guidance. The nidus was accessed with 11-gauge bone biopsy needle and then the stylet was removed and replaced by monopolar 16.5G radiofrequency probe with a 9-mm active tip through the coaxial axis. Power delivery via the radiofrequency generator was started at 2 W and increased gradually until the end point of 450-500 W reached and 'Roll-Off' achieved indicating coagulation necrosis of the target lesion. Results: The procedure was technically successful in all patients. The mean procedure time was 72 min and the mean RFA time was 12.7 min. The clinical success rate was 93%. In one patient, the procedure was abandoned due to immature Roll-Off despite all measures. In one patient (3%), recurrence occurred 39 months after the procedure. No major complications were encountered. Two minor skin burns occurred that were resolved with conservative measures. Conclusion: RFA of osteoid osteoma using Soloist monopolar electrode is a safe and effective treatment. Tissue impedance could be used as an alternative to temperature to indicate osteonecrosis of osteoid osteoma during RFA.

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Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Al-Omari¹,

Ata

Al-Muqbel³

et al. 2012

J Med Imag Rad Onc

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“…Although OO is benign and spontaneous remission occasionally occurs, an intervention for definitive relief of pain is sometimes required [2]. Among others techniques [3], radiofrequency ablation (RFA) is a minimally invasive technique which allows thermal destruction of the OO [4][5][6]. The most common location of OO is in the long bones [5].…”

Section: Introductionmentioning

confidence: 99%

“…In general, a constant temperature mode is clinically used with a target temperature of 90ºC and duration ranging from 240 s [4,[17][18][19] to 360 s [20]. We considered this same mode with a target temperature of 90°C and duration of 300 s. To implement the constant temperature mode we used the same approach as in [21], in which the authors considered a dynamic system for control purposes.…”

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confidence: 99%

Computer modelling of RF ablation in cortical osteoid osteoma: Assessment of the insulating effect of the reactive zone

Irastorza

Trujillo

Martel

et al. 2016

International Journal of Hyperthermia

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2 AbstractPurpose: To study by computer simulations the insulating role of the reactive zone surrounding a cortical osteoid osteoma (OO) in terms of electrical and thermal performance during radiofrequency ablation (RFA). Material and methods:We modeled a cortical OO consisting of a nidus (10 mm diameter) enclosed by a reactive zone. The OO is near a layer of cortical bone 1.5 mm thick. Trabecular bone partially surrounds the OO and there is muscle around the cortical bone layer. We modeled RF ablations with a non-cooled-tip 17G needle electrode (300 s duration and 90ºC target temperature). Sensitivity analyses were conducted assuming a reactive zone electrical conductivity value (σ rz ) within the limits of the cortical and trabecular bone, i.e. 0.02 S/m and 0.087 S/m, respectively. In this way we were really modeling the different degrees of osteosclerosis associated with the reactive zone. Results:The presence of the reactive zone drastically reduces the maximum temperature reached outside it. The temperature drop is proportional to the thickness of the reactive zone: from 68ºC when it is absent to 44ºC when it is 7.5 mm thick. Higher nidus conductivity values (σ n ) implied higher temperatures, while lower temperatures meant higher σ rz values. Changing σ rz from 0.02 S/m to 0.087 S/m reduced lesion diameters from 2.4 cm to 1.8 cm. Conclusions:The computer results suggest that the reactive zone plays the role of insulator in terms of reducing the temperature in the surrounding area.

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“…16 Investigators have successfully used RFA for management of spinal osteoid osteomas by using thermoprotective techniques for lesions as close as 1 mm to neural elements without complications (Figs 1 and 2). 15,16,22,[35][36][37][38][39][40] During RFA, patients under general anesthesia have a fairly predictable response with elevated heart (average increase, 40%) and respiratory rates (average increase, 50%) during both the biopsy and ablation portions of the treatment. 41 Morassi et al 40 treated 13 patients with spinal osteoid osteomas (11 in the posterior elements and 2 in the vertebral bodies) by using a non-cool-tip unipolar system with a 5-mm active tip (90°C for 6 minutes) using thermoprotection, achieving pain relief in 11 patients with no complications.…”

Section: 34mentioning

confidence: 99%

Benign Spine Lesions: Advances in Techniques for Minimally Invasive Percutaneous Treatment

Tomasian

Wallace

Jennings

2017

AJNR Am J Neuroradiol

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SUMMARY:Minimally invasive percutaneous imaging-guided techniques have been shown to be safe and effective for the treatment of benign tumors of the spine. Techniques available include a variety of tumor ablation technologies, including radiofrequency ablation, cryoablation, microwave ablation, alcohol ablation, and laser photocoagulation. Vertebral augmentation may be performed after ablation as part of the same procedure for fracture stabilization or prevention. Typically, the treatment goal in benign spine lesions is definitive cure. Painful benign spine lesions commonly encountered in daily practice include osteoid osteoma, osteoblastoma, vertebral hemangioma, aneurysmal bone cyst, Paget disease, and subacute/chronic Schmorl node. This review discusses the most recent advancement and use of minimally invasive percutaneous therapeutic options for the management of benign spine lesions. ABBREVIATIONS:PVA ϭ percutaneous vertebral augmentation; RF ϭ radiofrequency; RFA ϭ radiofrequency ablation

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Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation

Cited by 54 publications

References 19 publications

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Computer modelling of RF ablation in cortical osteoid osteoma: Assessment of the insulating effect of the reactive zone

Benign Spine Lesions: Advances in Techniques for Minimally Invasive Percutaneous Treatment

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