Ghanem Ismat
Pediatric Orthopaedic Surgery, Hotel-Dieu de France Hospital, Saint Joseph University, Achrafieh, Beirut, Lebanon.
Curr Opin Pediatr. 2006 Feb;18(1):36-41. doi: 10.1097/01.mop.0000193277.47119.15.
Osteoid osteoma is a benign painful bone tumor usually found in the lower extremities of children and young adults. It has been traditionally treated by surgical excision. Despite the small size of the lesion, the operative procedure for its removal can be extensive, but still sometimes remains incomplete. The purpose of this review is to highlight and discuss current developments in the management of osteoid osteoma.
During the past decade, efforts were deployed to minimize bone removal, lessen the risk of pathologic fracture and the need for bone grafting, and thereby shorten the period of convalescence. Improved methods for the precise localization of an osteoid osteoma with use of radioisotope scanning or computed tomography scan have made it possible to treat this lesion with more limited and effective operations, mainly in deep and non-easily accessible osteoid osteomas.
Although they bear the criticism of lacking histological proof for diagnosis of osteoid osteoma, minimally invasive techniques, such as computed tomography-guided percutaneous radiofrequency thermal ablation and laser photocoagulation have become the methods of choice for the treatment of all localizations except those in contact with neural structures (awaiting further research and experience), provided that the diagnosis is based on a typical clinical, scintigraphic and computed tomography presentation.
骨样骨瘤是一种良性疼痛性骨肿瘤，通常见于儿童和年轻成人的下肢。传统上通过手术切除进行治疗。尽管病变体积小，但切除手术范围可能较大，且有时仍不彻底。本综述的目的是强调并讨论骨样骨瘤治疗方面的当前进展。
在过去十年中，人们致力于尽量减少骨质切除，降低病理性骨折风险以及骨移植需求，从而缩短康复期。利用放射性同位素扫描或计算机断层扫描（CT）扫描改进了骨样骨瘤精确定位的方法，使得以更有限且有效的手术治疗该病变成为可能，主要用于深部且难以触及的骨样骨瘤。
尽管微创技术（如CT引导下经皮射频热消融和激光光凝）缺乏骨样骨瘤诊断的组织学证据而受到批评，但只要诊断基于典型的临床、闪烁扫描和CT表现，这些技术已成为除与神经结构接触部位（有待进一步研究和经验积累）之外所有部位骨样骨瘤的首选治疗方法。
