Osteoid osteoma of the spine treated with percutaneous computed tomography-guided thermocoagulation.
METHODS
Two cases are reported in which an osteoid osteoma of the lumbar spine was treated with CT-guided thermocoagulation.


OBJECTIVE
To review an alternative and minimally invasive treatment for spinal osteoid osteomas.


BACKGROUND
Surgical resection of a spinal osteoid osteoma can, depending on the location, be a formidable undertaking. Bone scintigraphy can be helpful in intraoperative identification. More recently, resection through a computed tomography-guided drill hole was found to minimize exposure. Using a thermocoagulation probe, as has been used in osteoid osteoma of the extremities, may be technically easier and cause less morbidity.


METHODS
With the patient under general anesthesia, a bone biopsy cannula was introduced into the center of the osteoid osteoma. Material was subjected to histologic examination. A thermocoagulation probe was then inserted and heated to 90 C for 4 minutes. The two patients were kept overnight for observation.


RESULTS
Both patients had complete pain relief and no evidence of recurrence after 2 years' follow-up. There were no complications. Scoliosis resolved in one patient and persisted in the other.


CONCLUSIONS
Percutaneous computed tomography-guided thermocoagulation is a minimally invasive and technically straightforward method to achieve ablation of a spinal osteoid osteoma. No complications were encountered in these two patients. Future research should focus on the safety of thermocoagulation, especially cephalad to the level of the conus medullaris.
Cové
J A
JA
Department of Orthopaedic Surgery, and the Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands. joscove@uswest.net
Taminiau
A H
AH
Obermann
W R
WR
Vanderschueren
G M
GM
D000293:Adolescent; D000328:Adult; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010017:Osteoma, Osteoid / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012600:Scoliosis / Q000209:etiology; D013125:Spinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed