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Percutaneous computed tomography-guided radiofrequency ablation of osteoid osteomas

  • Christos K. Kyriakopoulos
  • Andreas F. Mavrogenis
  • John Pappas
  • Panayiotis J. PapagelopoulosEmail author
Original Article

Abstract

Twenty-one consecutive patients with osteoid osteoma treated with computed tomography-guided radiofrequency ablation, after failed conservative treatment, were retrospectively reviewed. The diagnosis was based on typical clinical and imaging features. Radiofrequency ablation of osteoid osteomas was undertaken by heating the tip of the electrode to 90°C for three sessions of 2 min each. Follow-up evaluation included clinical examination and questionnaire, and radiographic evaluation was conducted on the first month, 12th month, and at the latest examination. Within the first 24 h post-procedure, pain was improved in all patients. Seven patients had pain relief within the first 3 days, 11 patients within the first week, and 3 patients within 2 weeks post-procedure. A month after the procedure, no patient had difficulty regarding self-care and daily activities. At a mean follow-up of 29 months (range 12–60 months), early or late complications and signs of local recurrence were not observed.

Keywords

Osteoid osteoma Radiofrequency ablation Computed tomography Magnetic resonance imaging Bone scan 

Ablation par Radiofréquence Percutanée sous Contrôle Tomodensitométrique des Ostéomes Ostéoïdes

Résumé

Vingt et un patients consécutifs porteurs d’ostéome ostéoïde ont été traités par radiofréquence sous contrôle tomodensitométrique. La diagnostic a été porté sur les signes cliniques et radiologiques pathognomoniques. L’intervention était pratiquée en chauffant l’électrode à 90° C pour trois séances de 2 minutes chacune. Le suivi consistait en un examen clinique accompagnée d’un questionnaire à compléter et en un contrôle radiologique réalisé le premier mois, le 12ème mois, et lors du dernier examen. Tous les patients voyaient leur douleur améliorée au cours des 24 premières heures. Une disparition totale de la douleur a été observée chez 7 patients dans les premiers 3 jours, chez 11 patients dans la première semaine, et chez 3 patients deux semaines après l’opération. Tous les patients ont recouvré une activité normale au bout d’un mois. Pour une durée moyenne de suivi de 29 mois (12–60 mois), au dernier recul, aucune récidive n’a été observée.

Mots clés

Ostéome ostéoïde Ablation par radiofréquence Tomodensitométrie Scintigraphie osseuse 

References

  1. 1.
    Adam GB, Keulers P, Vorwerk D, Günther RW (1995) CT-guided ethanol ablation of osteoid osteomas. Radiology 197(P):332Google Scholar
  2. 2.
    Assoun J, Railhac JJ, Bonnevialle P, Poey C, Salles de Gauzy J, Baunin C, Cahuzac JP, Clement JL, Coustets B, Railhac N (1993) Osteoid osteoma: percutaneous resection with CT guidance. Radiology 188:541–547PubMedGoogle Scholar
  3. 3.
    Assoun J, Richardi G, Railhac JJ, Baunin C, Fajadet P, Giron J, Maquin P, Haddad J, Bonnevialle P (1994) Osteoid osteoma: MR imaging versus CT. Radiology 191:217–223PubMedGoogle Scholar
  4. 4.
    Barei DP, Moreau G, Scarborough MT, Neel MD (2000) Percutaneous radiofrequency ablation of osteoid osteoma. Clin Orthop (373):115–124Google Scholar
  5. 5.
    Campanacci M (1999) Osteoid osteoma. In: Campanacci M, Enneking WF (eds) Bone and soft tissue tumors. Piccin Nuova Libraria SpA, Padova, pp 391–414Google Scholar
  6. 6.
    Cantwell CP, Obyrne J, Eustace S (2004) Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation. Eur Radiol 14(4):607–617PubMedCrossRefGoogle Scholar
  7. 7.
    Cioni R, Armillotta N, Bargellini I, Zampa V, Cappelli C, Vagli P et al (2004) CT-guided radiofrequency ablation of osteoid osteoma: long-term results. Eur Radiol 14(7):1203–1208PubMedCrossRefGoogle Scholar
  8. 8.
    De Berg JC, Pattynama PM, Obermann WR, Bode PJ, Vielvoye GJ, Taminiau AH (1995) Percutaneous computed-tomography-guided thermocoagulation for osteoid osteomas. Lancet 346(8971):350–351PubMedCrossRefGoogle Scholar
  9. 9.
    Duba SH, Schnatterbeck P, Harer T, Giehl J, Bohm P, Claussen CD (1997) Treatment of osteoid osteoma with CT-guided drilling and ethanol instillation. Dtsch Med Wochenschr 122(16):507–510Google Scholar
  10. 10.
    Gangi A, Dietemann JL, Gasser B, Mortazavi R, Dosch JC, Dupuis M et al (1997) Percutaneous laser photocoagulation of osteoid osteomas. Semin Musculoskelet Radiol 1(2):273–280PubMedCrossRefGoogle Scholar
  11. 11.
    Gangi A, Dietemann JL, Guth S, Vinclair L, Sibilia J, Mortazavi R, Steib JP, Roy C (1998) Percutaneous laser photocoagulation of spinal osteoid osteomas under CT guidance. AJNR Am J Neuroradiol 19:1955–1958PubMedGoogle Scholar
  12. 12.
    Kneisl JS, Simon MA (1992) Medical management compared with operative treatment for osteoid-osteoma. J Bone Joint Surg 74A:179–185Google Scholar
  13. 13.
    Lindner NJ, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wortler K (2001) Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg Br 83B:391–396CrossRefGoogle Scholar
  14. 14.
    Papagelopoulos PJ, Mavrogenis AF, Galanis EC, Kelekis NL, Wenger DE, Sim FH, Soucacos PN (2005) Minimally invasive techniques in orthopedic oncology: radiofrequency and laser thermal ablation. Orthopedics 28(6):563–568PubMedGoogle Scholar
  15. 15.
    Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MD, Mankin HJ (1998) Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg 80A:815–821Google Scholar
  16. 16.
    Saifuddin A, White J, Sherazi Z, Shaikh MI, Natali C, Ransford AO (1998) Osteoid osteoma and osteoblastoma of the spine. Factors associated with the presence of scoliosis. Spine 23:47–53PubMedCrossRefGoogle Scholar
  17. 17.
    Sans N, Galy-Fourcade D, Assoun J, Jarlaud T, Chiavassa H, Bonnevialle P et al (1999) Osteoid osteoma: CT-guided percutaneous resection and follow-up in 38 patients. Radiology 212(3):687–692PubMedGoogle Scholar
  18. 18.
    Towbin R, Kaye R, Meza MP, Pollock AN, Yaw K, Moreland M (1995) Osteoid osteoma: percutaneous excision using a CT-guided coaxial technique. AJR Am J Roentgenol 164:945–949PubMedGoogle Scholar
  19. 19.
    Vanderschueren GM, Taminiau AH, Obermann WR, Bloem JL (2002) Osteoid osteoma: clinical results with thermocoagulation. Radiology 224(1):82–86PubMedGoogle Scholar
  20. 20.
    Witt JD, Hall-Craggs MA, Ripley P, Cobb JP, Bown SG (2000) Interstitial laser photocoagulation for the treatment of osteoid osteoma. J Bone Joint Surg Br 82:1125–1128PubMedCrossRefGoogle Scholar
  21. 21.
    Woertler K, Vestring T, Boettner F, Winkelmann W, Heinkel W, Lindner N (2001) Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients. J Vasc Interv Radiol 12(6):717–722PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Christos K. Kyriakopoulos
    • 1
  • Andreas F. Mavrogenis
    • 1
  • John Pappas
    • 2
  • Panayiotis J. Papagelopoulos
    • 1
    Email author
  1. 1.First Department of OrthopaedicsAthens University Medical SchoolAthensGreece
  2. 2.Department of RadiologyHygeia Athens Medical CenterAthensGreece

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