title: Clinical long-term outcome, technical success, and cost analysis of radiofrequency ablation for the treatment of osteoblastomas and spinal osteoid osteomas in comparison to open surgical resection.
abstract: OBJECTIVE
  To assess the clinical success and costs of computed tomography (CT)-guided radiofrequency ablation (RFA) of osteoblastoma (OB) and spinal osteoid osteoma (OO).
  
  
  METHODS
  Nineteen patients with OB and eight patients with spinal OO were treated with CT-guided RFA. The OBs were localized in the extremities (n = 10), the vertebral column (n = 2), and (juxta-)articular (n = 7). Dedicated procedural techniques included three-dimensional CT-guided access planning in all cases, overlapping RFA needle positions (median, two positions; range, 1-6 RF-electrode positions) within the OB nidus (multiple ablation technique, n = 15), and thermal protection in case of adjacent neural structure in four spinal OO. The data of eight operated OB and ten operated spinal OO patients were used for comparison. Long-term success was assessed by clinical examination and using a questionnaire sent to all operated and RFA-treated patients including visual analogue scales (VAS) regarding the effect of RFA on severity of pain and limitations of daily activities (0-10, with 0 = no pain/limitation up to 10 = maximum or most imaginable pain/limitation).
  
  
  RESULTS
  All patients had a clear and persistent pain reduction until the end of follow-up. The mean VAS score for all spinal OO patients and all OB patients treated either with RFA or with surgical excision significantly decreased for severity of pain at night, severity of pain during the day, and both for limitations of daily and of sports activities.
  
  
  CONCLUSIONS
  RFA is an efficient method for treating OB and spinal OO and should be regarded as the first-line therapy after interdisciplinary individual case discussion.
authors.affiliation: Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany, marcandre.weber@med.uni-heidelberg.de.
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Weber
authors.forename: Simon David
authors.initials: SD
authors.lastname: Sprengel
authors.forename: Georg W
authors.initials: GW
authors.lastname: Omlor
authors.forename: Burkhard
authors.initials: B
authors.lastname: Lehner
authors.forename: Bernd
authors.initials: B
authors.lastname: Wiedenhöfer
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.forename: Christoph
authors.initials: C
authors.lastname: Rehnitz
mesh_terms: D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000191:economics* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018213:Neoplasms, Bone Tissue / Q000000981:diagnostic imaging / Q000191:economics* / Q000601:surgery*; D018215:Osteoblastoma / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery; D010027:Osteotomy / Q000191:economics* / Q000379:methods; D011859:Radiography; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000191:economics* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult