Barsa P, Suchomel P, Lukás R, Taller S, Endrych L
Neurochirurgické oddelení, Neurocentrum, Krajská nemocnice Liberec.
Acta Chir Orthop Traumatol Cech. 2007 Dec;74(6):401-5.
Radiofrequency ablation is a minimally invasive method indicated in the treatment of bone tumors. Its effectiveness and safety have been reported in a number of studies concerned with the therapy of osteoid osteoma of extremities. However, only scarce information is available on effectiveness of ablation in osteoid osteoma of the spine. The aim of the study was to verify the efficacy of percutaneous CT-guided radiofrequency ablation on this indication.
This prospective study included four patients, three women and one man, with osteoid osteoma of the lumbar or sacral spine who were treated by percutaneous CT-guided radiofrequency ablation in the period from February 2002 to March 2005. Two tumors were found in the third lumbar vertebra, one in the fourth lumbar and one in the first sacral verstebra. The pre-operative pain values assessed on the visual analogue scale (VAS), and function restriction rated by the Oswestry Disability Index (ODI) were compared with the post-operative values at 2 years after surgery. Patients' satisfaction with surgical outcome was evaluated according to Odom's criteria.
All four procedures were accomplished successfully in technical terms and the patients completed the two-year followup. All patients reported significant relief of pain immediately after surgery and this held even after 2 years. The average pre-operative VAS value of 8.3 was reduced to 2.45 at the final examination, and the pre-operative ODI of 70/100 improved to 95/100 post-operatively. The outcome of treatment rated by Odom's criteria was regarded as excellent.
Percutaneous CT-guided radiofrequency ablation is an effective and safe method for treatment of spinal osteoid osteoma. It has advantages that could make it preferable to surgical excision of tumors. Key words: osteoid osteoma, computed tomography, radiofrequency ablation.
射频消融是一种用于治疗骨肿瘤的微创方法。其有效性和安全性已在许多关于四肢骨样骨瘤治疗的研究中得到报道。然而，关于脊柱骨样骨瘤消融有效性的信息却很少。本研究的目的是验证经皮CT引导下射频消融治疗该疾病的疗效。
本前瞻性研究纳入了2002年2月至2005年3月期间接受经皮CT引导下射频消融治疗的4例腰椎或骶椎骨样骨瘤患者，其中3例女性，1例男性。在第三腰椎发现2个肿瘤，第四腰椎1个，第一骶椎1个。将术前视觉模拟量表（VAS）评估的疼痛值和Oswestry功能障碍指数（ODI）评定的功能受限情况与术后2年的数值进行比较。根据奥多姆标准评估患者对手术结果的满意度。
从技术角度来看，所有4例手术均成功完成，患者完成了两年的随访。所有患者术后立即报告疼痛明显缓解，且2年后依然如此。最终检查时，术前平均VAS值8.3降至2.45，术前ODI值70/100术后改善至95/100。根据奥多姆标准评定的治疗结果为优秀。
经皮CT引导下射频消融是治疗脊柱骨样骨瘤的一种有效且安全的方法。它具有一些优点，使其可能比手术切除肿瘤更具优势。关键词：骨样骨瘤；计算机断层扫描；射频消融
