Osteoid osteoma treated with computed tomography-guided percutaneous radiofrequency ablation: a case series.
The nidi of osteoid osteoma are small and difficult to identify precisely; this can necessitate substantial resection of the surrounding normal bone. We applied percutaneous, image-guided radiofrequency ablation to treat 5 patients with osteoid osteoma. The precise location of each nidus was determined using a 3-mm-thick spiral computed tomographic scan. The most appropriate needle pathway was selected to avoid major neural and vascular structures. A 14-gauge core needle was introduced into the nidus and then exchanged for a 17-gauge straight rigid electrode with a 1-cm exposed tip to heat the lesion to 90 degrees centigrade for 5 minutes. Four of the 5 patients were discharged on the day after surgery without any external supports, and were pain-free after a few days. The remaining patient had a pes equinus contracture induced by the penetration of the calf muscles through a posterior approach but was fully recovered 6 days later. The mean follow-up period was 20.6 months. No recurrences or late complications were observed in this series. This case series shows that the computed tomography-guided percutaneous radiofrequency ablation is a simple, minimally invasive, and highly effective technique for the treatment of osteoid osteoma.
Shinozaki
T
T
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. tshinoza@showa.gunma-u.ac.jp
Sato
J
J
Watanabe
H
H
Takagishi
K
K
Aoki
J
J
Koyama
Y
Y
Takahashi
A
A
D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D002648:Child; D005260:Female; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000601:surgery*; D015642:Radiology, Interventional; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D013977:Tibia; D014057:Tomography, X-Ray Computed