Mastrantuono Donato, Martorano Domenico, Verna Valter, Mancini Andrea, Faletti Carlo
Dipartimento di Diagnostica per Immagini, U.O.A. di Radiologia Diagnostica C.T.O., Turin.
Radiol Med. 2005 Mar;109(3):220-8.
To present the results of two years experience with a minimally invasive radio-frequency technique designed by our team in the treatment of osteoid osteoma.
A total of 21 osteoid osteoma patients (15 males, 6 females, age range 13 to 34 yrs) were treated between January 2001 and April 2003. Localizations of the osteoid osteoma were the pelvis (n = 1), the femur (n = 12), the tibia (n = 3), the foot (n = 3), and the humerus (n = 2). All patients underwent an X-ray examination, a CT scan and a bone Scintiscan. In the initial phase, a K-wire just slightly larger than the 17G needle electrode is positioned manually at the zenith of the target area under CT guidance and using an orthopaedic drill it is inserted at the centre of the nidus. A tailor-made metal sheath is inserted on the K-wire to create a ''tunnel'' through which the needle electrode can substitute the K-wire; at the same time, the electrode needle is positioned inside the lesion. The temperature of the exposed tip of the needle is 90 degrees C and duration of hyperthermia is 6 minutes on average. Once the procedure has been completed, a scan os performed to measure the density of the treated site and this measurement is then used as an evolution index for the evaluation of the healing process during follow-up.
No serious complications were observed at follow-up. General anaesthesia was only required in the case with hip involvement; peripheral anaesthesia was used in all the other cases. Complete resolution of the pain was reported in all cases after a maximum of three weeks.
After two years experience, we believe percutaneous RF treatment of osteoid osteoma to be the first choice technique when compared to traditional surgery due to the fact that it is almost non-invasive, quick, repeatable if need be and offers a high reduction in costs. Moreover early weight bearing is the norm and the patient is dismissed after only one day of hospitalization. The clinical results indicate a 100% success rate with complete remission of symptoms and no relapses having been reported at the time of writing for those patients who have arrived at the two year follow up (4 out of 21).
介绍我们团队设计的一种微创射频技术治疗骨样骨瘤两年的经验结果。
2001年1月至2003年4月期间共治疗21例骨样骨瘤患者（男15例，女6例，年龄13至34岁）。骨样骨瘤的部位为骨盆（n = 1）、股骨（n = 12）、胫骨（n = 3）、足部（n = 3）和肱骨（n = 2）。所有患者均接受了X线检查、CT扫描和骨闪烁扫描。在初始阶段，在CT引导下手动将一根略大于17G针电极的克氏针置于目标区域的顶点，并用骨科钻将其插入病灶中心。将特制的金属鞘插入克氏针上以形成一个“通道”，针电极可通过该通道替代克氏针；同时，将电极针置于病灶内。针外露尖端的温度为90℃，热疗持续时间平均为6分钟。手术完成后，进行扫描以测量治疗部位的密度，该测量结果随后用作随访期间评估愈合过程的演变指标。
随访期间未观察到严重并发症。仅髋关节受累的病例需要全身麻醉；其他所有病例均采用局部麻醉。所有病例在最多三周后疼痛完全缓解。
经过两年的经验，我们认为与传统手术相比，经皮射频治疗骨样骨瘤是首选技术，因为它几乎无创、快速、必要时可重复且成本大幅降低。此外，早期负重是常规做法，患者仅住院一天后即可出院。临床结果显示成功率为100%，症状完全缓解，截至撰写本文时，在两年随访的患者中（21例中的4例）未报告复发情况。
