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Osteoidosteom

CT-gesteuerte Bohrexzision und Radiofrequenzablation

Osteoid osteoma

CT guided drilling and radiofrequency ablation

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Zusammenfassung

Hintergrund

Die CT-geführte Entfernung des Nidus eines Osteoidosteoms anstelle herkömmlicher Verfahren der offenen Resektion bietet den Vorteil, die Läsion intraoperativ exakt zu lokalisieren und deren Entfernung korrekt zu kontrollieren. Zudem tritt anstelle eines oft großen Eingriffs der Vorteil eines minimal-invasiven Vorgehens.

Patienten und Methode

Zwischen 1996 und 2005 wurden 52 Patienten anhand von Klinik und Bildgebung diagnostizierten Osteoidosteomen entweder mittels Bohrexzision (BE, n=41) oder Radiofrequenzablation (RFA, n=11) behandelt. Das Alter der Patienten lag zwischen 7 und 48 (Durchschnitt 22,3) Jahren, der Follow-up betrug 31,3 Monate.

Ergebnisse

Das Osteoidosteom konnte bei allen Patienten erfolgreich behandelt werden. 50 Patienten waren nach einmaligem Eingriff anhaltend beschwerdefrei. Bei 2 Patienten wurde in der 1. Operation der Nidus verfehlt, sodass kurze Zeit später mit der gleichen Methode eine 2. Behandlung notwendig wurde.

Schlussfolgerung

Die CT-geführte Therapie des Osteoidosteoms hat dessen Behandlung durch exakte Lokalisierung und Verkleinerung des Eingriffs entscheidend vereinfacht und besser kontrollierbar gemacht. Das Verfahren kann analog zur Biopsie von Weichteil- und Knochenprozessen genutzt werden, was den Vorteil der exakten Dokumentation des Biopsieweges und der Entnahmestelle bietet.

Abstract

Background

The CT-guided therapy of osteoid osteoma instead of older methods such as open resection has the advantage of exact localization of the nidus intraoperatively and exact documentation of its ablation. Another advantage is the less invasive approach.

Patients and methods

A total of 52 patients with osteoid osteoma were treated in our institution between 1996 and 2005 either by radiofrequency ablation (n=11) or by percutaneous resection under CT guidance (n=41). Their age was between 7 and 48 years, mean age was 22.3 years, and follow-up was 31.3 months.

Results

In all patients (n=52) the osteoid osteoma was successfully treated. In 50 patients the first treatment resulted in long-term success. In two patients the nidus was first missed; they were successfully treated with another operation using the same technique.

Conclusion

The CT-guided operation of osteoid osteoma made the therapy much easier because of the exact localization and the less invasive approach. This technique can be used analogously to tumor biopsy. The advantage is the exact documentation of the biopsy path and the possibility to take specimens.

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Authors and Affiliations

  1. Radiologische Abteilung, Universitätsklinik Balgrist, Zürich, Schweiz

    S. Duc

  2. Orthopädische Universitätsklinik Balgrist, Forchstraße 340, CH-8008 , Zürich, Schweiz

    L. E. Ramseier & G. U. Exner

Authors
  1. L. E. Ramseier
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  2. S. Duc
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  3. G. U. Exner
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Correspondence to L. E. Ramseier.

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Ramseier, L.E., Duc, S. & Exner, G.U. Osteoidosteom. Orthopäde 35, 989–994 (2006). https://doi.org/10.1007/s00132-006-0960-8

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  • DOI: https://doi.org/10.1007/s00132-006-0960-8

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