Abstract No. 230 Percutaneous ablation for the treatment of osteoid osteomas: a systematic review and meta-analysis

Abstract

To evaluate the safety and efficacy of percutaneous ablative therapy for the treatment of osteoid osteomas. PubMed database, Web of Science, and SCOPUS were searched from their inception until November 2019 for articles describing osteoid osteoma. Inclusion criteria were as follows: studies reporting > 5 patients, and pre- and post-procedure pain assessment recorded with Visual Analog Scale (VAS). Demographic data, procedural details, technical success rates, pre- and post-procedure VAS scores, and procedural complications were recorded. A random-effects meta-analyses of the VAS pain score pre-procedurally, at 24-48 hours, at 3-6 months, and at 12 months were calculated. For radiofrequency ablation, VAS scores for pain at pre-procedure, 24-48 hours, and 3-6 months yielded cumulative pain scores of 7.64 ± 0.175 (1023 patients), 0.78 ± 0.186 (1009 patients), and 0.02 ± 0.0196 (1009 patients), respectively. For cryoablation, VAS scores for pain at pre-procedure, 24-48 hours, and 3-6 months yielded cumulative pain scores of 8.46 ± 0.549 (75 patients), 0.975 ± 0.66 (75 patients), and 0.112 ± 0.08 (75 patients), respectively. For laser ablation, VAS scores for pain at pre-procedure and 24-48 hours yielded cumulative pain scores of 4.94 ± 1.42 (59 patients), and 0.506 ± 0.268 (276 patients), respectively. Though the mean follow-up time for patients undergoing laser ablation was 49.15 ± 25.25 months, VAS scores were not reported 3-6 months post-procedure. For microwave ablation, VAS scores for pain at pre-procedure, 24-48 hours, and 3-6 months yielded cumulative pain scores of 6.14 ± 1.07 (7 patients), 1.636 ± 1.215 (44 patients), and 0 ± 0.0 (24 patients), respectively. All ablation methods resulted in a significant immediate and lasting pain reduction (P< 0.001). Overall recurrence of bone pain at the same site occurred in 4.07% of all patients an average of 11 months post-procedure. Percutaneous ablative therapies are safe and result in significant and lasting pain reduction as demonstrated through Visual Analog Scale pain scores.Tabled 1VAS PreprocedureVAS 24-48 Hours PostprocedureVAS 3-6 Months PostprocedureRadiofrequency ablation7.64 ± 0.175 (n = 1023)0.78 ± 0.186 (n = 1009)0.02 ± 0.0196 (n = 1009)Laser ablation4.94 ± 1.42 (n = 59)0.506 ± 0.268 (n = 276)-Cryoablation8.46 ± 0.549 (n = 75)0.975 ± 0.66 (n = 75)0.112 ± 0.08 (n = 75)Microwave ablation6.14 ± 1.07 (n = 7)1.636 ± 1.215 (n = 44)0 ± 0.0 (n = 24) Open table in a new tab