[Treatment of osteoid osteoma using laser photocoagulation. Apropos of 28 cases].
THE PURPOSE OF THE STUDY was to evaluate interstitial laser photocoagulation for local destruction of osteoid osteoma, with computed tomographic (CT) guidance.


METHODS
28 patients (age range from 5 to 48 years) with presumed osteoid osteoma were treated with CT-guided interstitial laser photocoagulation of the nidus. A high power semiconductor diode laser (805 nm) with a 400 microns optical fiber was used. The fiber was introduced into the nidus through a 18-gauge needle. Around the fiber tip, well-defined coagulative necroses from 5 to 9 mm (energy delivery, 400-1000J) were obtained.


RESULTS
27 patients had complete pain relief, which was effective within 24 hours in 18 patients. One patient had pain recurrence after 6 weeks. The remaining nidus was treated secondarily with complete relief. Treatment was unsuccessful in one patient, and surgical excision was performed. All patients were followed up for more than 1 year, with no sign of recurrence. The only notable complication was a mild reflex sympathetic dystrophy of the wrist in one patient. Sclerosis of the nidus was observed 6-12 months after the procedure.


CONCLUSIONS
Percutaneous interstitial laser photocoagulation of osteoid osteoma seems to be a promising, simple, precise, and minimally invasive alternative to traditional surgical and percutaneous ablations.
Gangi
A
A
Services de Radiologie, Hôpitaux Universitaires de Strasbourg.
Dietemann
J L
JL
Clavert
J M
JM
Dodelin
A
A
Mortazavi
R
R
Durckel
J
J
Roy
C
C
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D017075:Laser Coagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D055100:Optical Fibers; D010017:Osteoma, Osteoid / Q000601:surgery*; D010146:Pain / Q000601:surgery; D015641:Radiography, Interventional; D012019:Reflex Sympathetic Dystrophy / Q000209:etiology; D012086:Reoperation; D012598:Sclerosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome