Thermal Ablation of Osteoid Osteoma: Overview and Step-by-Step Guide

Motamedi, Daria; Learch, Thomas J.; Ishimitsu, David N.; Motamedi, Kambiz; Katz, Michael; Brien, Earl W.; Menendez, Lawrence R.

doi:10.1148/rg.297095081

Cited by 147 publications

(160 citation statements)

References 22 publications

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“…If nonoperative treatment fails, the subsequent alternative would be surgery. Currently percutaneous radiofrequency ablation is the minimally invasive surgery recommended if the site of the osteoid osteoma permits [29], as in an osteoid osteoma located in the extremities. However, an osteoid osteoma located in the posterior arch, pedicle, or posterior wall of the vertebral body carries a high surgical risk of neurovascular damage (thermal damage) because the target is close to the spinal cord, nerve roots, and arteries [34].…”

Section: Discussionmentioning

confidence: 99%

Case Report: Curetting Osteoid Osteoma of the Spine Using Combined Video-assisted Thoracoscopic Surgery and Navigation

Campos

Gasbarrini

Boriani

2013

Clinical Orthopaedics &Amp; Related Research

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Background A spinal osteoid osteoma is a rare benign tumor. The usual treatment involves complete curettage including the nidus. In the thoracic spine, conventional open surgical treatment usually carries relatively high surgical risks because of the close anatomic relationship to the spinal cord, nerve roots, and thoracic vessels, and pulmonary complications and postoperative pain. Case Report We report the case of a 16-year-old girl with a symptomatic osteoid osteoma at the T9 level whose lesion was currettaged using video-assisted thoracoscopic surgery (VATS) guided by a navigation system (VATS-NAV). There were no complications and the patient had immediate relief of the characteristic pain after surgery and was asymptomatic at 5 months' followup. Literature Review Progressive advances in the technology of spinal surgery have evolved to offer greater safety and less morbidity for patients. The advent of minimally invasive surgery has expanded the indications for VATS for anterior spinal disorders. Spinal navigation systems have become useful tools allowing localization and excision of the nidus of osteoid osteomas with minimal bone resection and without radiation exposure. Clinical Relevance The VATS-NAV combination in our patient allowed accurate localization and guidance for complete excision of a spinal osteoid osteoma through a minimally invasive approach without compromising spinal stability.

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Section: Discussionmentioning

confidence: 99%

Case Report: Curetting Osteoid Osteoma of the Spine Using Combined Video-assisted Thoracoscopic Surgery and Navigation

Campos

Gasbarrini

Boriani

2013

Clinical Orthopaedics &Amp; Related Research

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“…O steoid osteoma (OO) is a benign bone tumor of childhood and adolescence (1)(2)(3), which typically causes severe bone pain that worsens during nighttime. In addition to conservative long-term treatment with nonsteroid anti-inflammatory drugs-which is problematic due to the side effects-the surgical resection of the nidus and several recently introduced minimally invasive therapies are treatment options for OO (4)(5)(6).…”

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confidence: 99%

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

Rehnitz¹,

Sprengel²,

Lehner³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to retrospectively evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) findings of patients with osteoid osteoma treated with CT-guided radiofrequency ablation (RFA) along with the clinical outcome and long-term success. MATERIALS AND METHODSSeventy-three CT-guided RFA procedures were performed in 72 patients. The long-term success was assessed using a questionnaire including several visual analog scale scores. The CT evaluation included pre-and immediate postprocedural imaging of all 72 patients, and MRI was performed in 18 patients with follow-up imaging (mean, 3.4±2.2 months). The evaluation criteria included nidus morphology and a correlation with markers of clinical success. RESULTSThe primary technique effectiveness rate was 71/72 (99%). One relapse was successfully retreated, leading to a secondary technique effectiveness rate of 72/72 (100%). The longterm follow-up (mean, 51.2±31.2 months; range, 3-109 months) revealed a highly significant reduction of all assessed limitation scores (P < 0.001). The CT morphology was typical in all cases and did not change during the short-term follow-up. The follow-up MRI patterns varied considerably, including persistent nidus contrast enhancement in one-third (6/18) and persistent marrow edema in half (9/18) of the patients. None of the investigated MRI and CT patterns correlated with the clinical outcome. CONCLUSIONThe long-term outcome of CT-guided RFA of osteoid osteoma is excellent. There is no correlation of the CT and MRI patterns with the clinical outcome. Thus, the treatment decisions should not be solely based on the imaging findings. Investigators should also be aware of the variety of imaging patterns after RFA.

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“…Other percutaneous techniques have been proposed, such as laser thermal therapy, cryotherapy, and ethanol therapy [1,2,26,27]. CT-guided RFA has become the preferred method owing to a low morbidity rate, minimal postoperative complications, minimal tissue exposure, rapid recovery, and no restriction of weightbearing activity [10,14,33,50,60,69]. In addition, the healing rate is 76% to 100% [14,53], with a major complication rate of 0% to 5% [2,6,45].…”

Section: Discussionmentioning

confidence: 99%

Case Report: Osteoid Osteoma of the Acetabulum Treated With Arthroscopy-assisted Radiofrequency Ablation

Ricci

Grappiolo

Franco

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Osteoid osteomas consist of a nidus surrounded by reactive sclerotic bone. The diagnosis typically is based on imaging and clinical presentation involving nocturnal pain. Removal of the lesion is essential and currently is performed mainly with image-guided, minimally invasive techniques. We describe a case involving an osteoid osteoma of the acetabular fossa, treated with arthroscopy-assisted radiofrequency ablation. Case Description A 47-year-old woman presented with a 9-month history of right groin pain and limited motion. The CT and MR images showed synovitis around the ligamentum teres and a nidus of the acetabular fossa, surrounded by sclerotic bone and protruding from the inner part of the lamina quadrilateral. Synovectomy and debridement of the ligamentum teres were performed, followed by radiofrequency ablation of the osteoid osteoma under direct arthroscopic observation of the hip, avoiding resection of the normal bone around the nidus and preserving the integrity of the quadrilateral lamina and cartilage. The patient had complete pain relief the next day with minimal morbidity and rapid functional restoration. At the 22-month clinical followup, the patient was asymptomatic, and the CT and MR images obtained 1 year after surgery showed no pathologic signs or synovitis. Literature Review Our case was the fifth such case to be treated with hip arthroscopy and the first of these to our knowledge to be treated with the arthroscopy-assisted radiofrequency ablation technique. Purposes and Clinical Relevance Arthroscopy-assisted radiofrequency ablation is a combined treatment technique that may be used for intraarticular lesions of the hip that otherwise would require a difficult approach and jeopardize damage to cartilage and bone and also treat concomitant synovitis.

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Thermal Ablation of Osteoid Osteoma: Overview and Step-by-Step Guide

Cited by 147 publications

References 22 publications

Case Report: Curetting Osteoid Osteoma of the Spine Using Combined Video-assisted Thoracoscopic Surgery and Navigation

Case Report: Curetting Osteoid Osteoma of the Spine Using Combined Video-assisted Thoracoscopic Surgery and Navigation

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

Case Report: Osteoid Osteoma of the Acetabulum Treated With Arthroscopy-assisted Radiofrequency Ablation

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