Preponderance of precise open excision surgery to treat osteoid osteoma

Abstract

PurposeThe aim of this retrospective study was to evaluate the efficacy of precise open excision surgery to treat osteoid osteoma with C-arm assisted precise localization during the operation.MethodsFrom June 2010 to June 2017, patients with osteoid osteoma of the extremities who had undergone treatment by high speed burr grinding, full scratching with curette, and C-arm assisted lesion localization during the operation were analyzed retrospectively. The preoperative and postoperative pain was assessed by the visual analogue scale (VAS) scoring. The patients were followed up regularly, and the advantages, effects, and complications of the therapeutic technique were analyzed.ResultsThe study consisted of 94 patients (59 males, 35 females; mean age, 17.6 ± 8.5 years) and they were followed up for a mean of 38.9 months (range, 24–72 months). All patients were diagnosed with osteoid osteoma by postoperative pathological examination. Follow-up consisted of imaging reexamination and clinical evaluation. If the patients did not take non-steroidal anti-inflammatory drugs (NSAIDs) before the operation, the mean pre-operative VAS score was 6.7, and the mean VAS score of all patients was 0 one month after operation. The mean time for all patients to resume normal daily activities was 14.3 days (range, 10-21 days). There was no recurrence of pain, infection, vascular or nerve injury, and fracture complications during the follow-up. In only one case of distal femur osteoid osteoma (OO), review X-ray found a suspected recurrence 50 months after the primary surgery and subsequently, the patient underwent a second surgery. Till date, the patient has reported no discomfort following the second surgery.ConclusionsFor treatment of osteoid osteoma, open incision and minimal resection with C-arm assisted tumor localization is still a suitable method, especially for osteoid osteoma located on the surface of the cortical bone.