Management Of Osteoid Osteoma Research Articles

Advances in Management of Osteoid Osteoma by Radiofrequency Ablation

Background Osteoid Osteoma is a benign painful skeletal neoplasm which is usually smaller than 1.5 cm. Surgery has been considered its standard treatment, currently, Percutaneous CT-guided Radiofrequency Ablation is proved to be the treatment of choice in such cases. Objective To evaluate the effectiveness of CT-guided radiofrequency ablation for the treatment of spinal and non-spinal osteoid osteomas, technical requirements needed for safe radiofrequency ablation and recent advances in this respect. Patients and Methods This study is a retrospective study conducted on patients with osteoid osteoma who underwent Radiofrequency ablation from January 2019 till July 2020 at Ain Shams University Hospitals, Maadi Military Hospital and El Galaa Military Hospital, followed by postprocedure computed tomography (CT) follow up. Results Location, calcification of the nidus, coagulation time, lesion size, and previous treatment are dependent risk factors compared regarding outcome. Conclusion We concluded that CT-guided RFA is a feasible, safe, and effective treatment for spinal and extra-spinal osteoid osteoma and is easily repeatable after unsuccessful treatment. Surgery should be reserved for lesions causing nerve root compression in spinal lesions.

Léčení osteoid osteomu v neobvyklých lokalizacích

Léčení osteoid osteomu v neobvyklých lokalizacích

Computed Tomography-Guided Radiofrequency Ablation of Osteoid Osteoma in Atypical Sites: Efficacy and Safety in a Large Case Series

Although computed tomography (CT) guided radiofrequency ablation (RFA) is accepted as the gold standard treatment for osteoid osteoma (OO) in extremities, most researchers have omitted OO in critical sites. We aimed to evaluate the efficacy and safety of CT-guided RFA in the management of OO in atypical sites. A prospective interventional study conducted on 34 patients (12 women and 22 men; mean age, 22.3 ± 3.5 years; range, 12-48 years) with OO in atypical sites. All patients were treated with CT-guided RFA. All procedures were performed under general anesthesia using a single straight, rigid RF electrode for 6 minutes at 90°C. All patients were followed up; technical and clinical successes of treatment were evaluated. The severity of pain was assessed on a visual analogue scale (VAS). CT-guided RFA was performed in all patients with 100% technical success and 100% primary clinical success. All patients had complete pain relief and returned to their quality of life without further analgesics within 1 month after the procedure. All procedures were successfully completed without any major complications. The mean preprocedure VAS score dropped to zero by the end of the first week with a highly statistically significant difference (p < 0.001). CT-guided RFA is a safe and effective procedure in the management of OO in atypical sites with 100% primary success rate, 0% long-term recurrence rate, and very low complication rate.

Management of Osteoid Osteoma Using Radiofrequency Ablation

Background: Osteoid osteomas (OO) are the third most common benign bone tumors affecting mostly children and adolescents with more tendency toward males. There are different treatment options consisting of medical therapy . Of note percutaneous thermal ablation (PTA) procedures that refer to radio frequency ablation (RFA) and interstitial laser photocoagulation (ILP) have also been recently applied with high success rates. Objectives: We aimed to assess the safety and outcomes of RFL and ILP in patients with OO as well as compare the efficacy of these two procedures. Patients and Methods: Medical records of 60 OO patients were retrospectively reviewed. Patients were divided into two groups, of which 40 underwent RFA procedures and 20 went through ILP. All patients were followed up clinically either through telephone interview or outpatient clinic visit and imaging was conducted in case signs and symptoms recurred. Results: In patients who underwent RFA, pain was relieved within 1 - 7 days in 35, and 1 - 3 months in five patients. Primary and secondary clinical effectiveness were 90.00% and 92.50%, respectively. In ILP, the technical success rate was 100% and the initial clinical success rate was 85.00%. Conclusion: Similar to previous published studies, this study showed high success rates for both RFA and ILA. Total pain relief occurred in 96.6% of the patients.

Minimally invasive CT-guided excision of osteoid osteoma and other small benign bone tumours: a single centre case series in South Africa

Background: The management of osteoid osteoma (OO) and other small primary benign lesions of bone has evolved over the past 50 years from open surgery with wide resection margins to less invasive surgical techniques such as image-guided intralesional excision and percutaneous radiofrequency ablation. We aim to evaluate the outcomes of patients treated with computerised tomography (CT-guided) intralesional excision and bone grafting of small benign lesions of bone. Method: A retrospective folder review of patients treated in a large academic hospital in Cape Town, South Africa, between March 2012 and May 2016 was performed. Patient demographics, details of presentation, clinical information and outcome following treatment were analysed descriptively. Pre-operative diagnosis based on radiological examination was compared with histological diagnosis. Result: Eleven patients (five male) with a median age of 16 years (range 5–33) were included. Pain was the most common presenting feature. A histological diagnosis of OO was confirmed in five of nine patients with a suspected diagnosis of OO pre-operatively. Of the four patients whose diagnosis changed after the procedure, the diagnoses included a benign spindle cell lesion, a benign fibrous histiocytoma, subacute osteitis and an osteochondral defect with geode cyst formation. Of the two patients where OO was not suspected pre-operatively, chondroblastoma was confirmed in one while a benign spindle cell lesion was reported in the other.Overall histological yield was thus 100%. There were no complications or repeat procedures at a median follow-up of 42 months (range 30–52 months). Conclusion: CT-guided intralesional curettage is a safe and minimally invasive technique. This is especially useful in less accessible regions of the skeleton as it provides a means of accurately locating the lesion with minimal risk of complications and morbidity to the patient. We consider this to be the optimal method of treatment in our setting as it provides high success rates, few complications and a histological diagnosis without the need for any additional and expensive equipment. Level of evidence: Level 4

Percutaneous CT guided radiofrequency thermoablation versus Magnetic Resonance guided Focalized Ultrasound Surgery (MrgFUS) in the treatment of Osteoid Osteoma. Critical evaluation of the indications

Background MRgFUS represent a new therapeutic option for the non-surgical management of osteoid osteoma. The site of the lesion is the most significant limitation of use of this technique. Purpose of this study is to compare the clinical and morphological two years after the procedure, of the treatment of 28 osteoid osteomas with Magnetic Resonance guided Focus Ultrasound Surgery (MRgFUS) versus the treatment with Radiofrequency termoablation (RF).

Thermocoagulation percutanée scannoguidée de l’ostéome ostéoïde

Purpose of the study Progress in Medical imaging has improved recognition and management of osteoid osteoma. The purpose of this study was to assess the efficacy of computed tomography (CT)-guided percutaneous thermal ablation and discuss the advantages and disadvantages. Material and methods We reviewed retrospectively 33 consecutive patients with osteoid osteoma who had undergone CT-guided radiofrequency ablation. The diagnosis was established on the basis of the clinical presentation and pathognomonic radiographic findings (CT and bone scintigram) without histological proof. We recorded patient age and gender, tumor location, clinical signs and duration, imaging findings, duration of the ablation procedure, type of anesthesia, hospital stay, and complications. We evaluated their effect on final outcome. Results Weight-bearing was possible in all patients with a lesion of the lower limb a few hours after surgery. Patients resumed their normal activities in 24-48 hours. Pain resolved immediately after radiofrequency ablation in 26 patients and limping, when present, disappeared within 24 hours. At mean follow-up of 34 months (minimum 12 months) there was one case of recurrent pain. Clinical cure was confirmed by CT and bone scintigraphy in twelve patients. Discussion and conclusion This precise and minimally invasive method is an effective and safe way to reduce healthcare expenditures. It can be recommended as the primary treatment for osteoid osteoma.

The Role of Imaging in the Diagnosis and Management of Osteoid Osteoma: A Pictorial Review

The Role of Imaging in the Diagnosis and Management of Osteoid Osteoma: A Pictorial Review

The Role of Imaging in the Diagnosis and Management of Osteoid Osteoma: A Pictorial Review

(2001). The Role of Imaging in the Diagnosis and Management of Osteoid Osteoma: A Pictorial Review. Critical Reviews in Diagnostic Imaging: Vol. 42, No. 6, pp. 357-377.