Percutaneous Endoscopic Excision and Ablation of Osteoid Osteoma of the Lumbar Spine and Sacrum: A Technical Note and Outcomes

Abstract

This study aimed to present a new endoscopic technique for osteoid osteoma (OO) of the lumbar spine and sacrum and to evaluate its safety and effectiveness. Eleven consecutive patients with spinal OO underwent percutaneous endoscopic excision and ablation (PEEA) between March 2014 and May 2018. A cannula 0.7 cm in diameter was used for the procedure. According to the size of the nidus, whole-piece removal and piecemeal intralesional resection were used. Afterward, ablation was performed using an endoscopic radiofrequency electrode in the residual osteoma cavities. Clinical outcomes were assessed by Visual Analog Scale (VAS) scores. The efficacy of this technique was assessed using relevant clinical data and postoperative radiographs. The niduses of the 11 patients were all located in the posterior element of the lumbar spine and sacrum (10 in the lumbar spine and 1 in the sacrum). The preoperative VAS score was 7.18 (range, 6-9), the score on postoperative day 1 was 1 (range, 0-2), and the last follow-up VAS score was 0.27 (range, 0-1). All patients were discharged within 24 hours after surgery. The mean follow-up period was 21.8 months (range, 12-36 months). No serious complications were observed during the follow-up period. PEEA is a safe and effective technique for OO in the lumbar spine and sacrum in which the nidus is located in the posterior element. However, it has a steep learning curve. Further research with a larger and more comprehensive sample population is warranted.