Experience of neuroprotective air injection during radiofrequency ablation (RFA) of spinal osteoid osteoma

Musculoskeletal
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Abstract

Purpose

To assess the usefulness of epidural air injection during the RFA treatment of spinal osteoid osteoma.

Methods

A retrospective review of 17 patients who underwent RFA for spinal osteoid osteoma between September 2006 and May 2017 was performed. All the procedures were performed by a single radiologist. We reviewed the perioperative CT studies to assess the distribution of air relative to the osteoid osteoma. The clinical outcome of each patient group was evaluated during routine follow-up.

Results

Seventeen patients were treated for spinal OO (male:female 13:4; mean age was 16, ranging from 4 to 42). The nidus size ranged from 5.8 to 17.2 mm (mean 11.2). In nine cases epidural air injection was performed. In three cases the neuroprotective air was deemed satisfactory with a clear layer of air between the osteoid osteoma and the dural sac being visualised. In six patients adherence between the cortical bone immediately adjacent to the osteoid osteoma and the dural sac in contact was observed.

In 15 patients the procedure was successful in terms of pain relief. No neural damage or other complication was reported in either group.

Conclusion

RFA is a safe treatment for spinal osteoid osteoma. Neuroprotective air injection does not appear to be necessary when performing the treatment in the spine.

Key Points

• Seventeen patients with spinal OO were treated with RFA, nine with air injection and eight without. Clinically successful treatment was achieved in 15 patients, with 2 subsequently undergoing surgery

• In 6/9 cases the injected air failed to achieve separation between the osteoid osteoma and the thecal sac because of inflammatory adhesion

• No complications were observed, regardless of whether neuroprotective air was instilled. Neuroprotective air injection appears unnecessary when treating spinal OO

Keywords

Osteoid osteoma Neuroprotection Vertebral column Interventional radiology Tomography 

Abbreviations

OO

Osteoid osteoma

MSK

Musculoskeletal

RFA

Radiofrequency ablation

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr Steven James.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Musculoskeletal RadiologyRoyal Orthopaedic Hospital NHS Foundation TrustBirminghamUK
  2. 2.Spinal Surgical UnitRoyal Orthopaedic Hospital NHS Foundation TrustBirminghamUK

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