Liberman Boaz, Gerniak Alexander, Eshed Iris, Chechick Ahron, Weiss Israel, Shabshin Noga
0rthopedic Oncology Service, Chaim Sheba Medical Center, Tel Hashomer Israel.
Harefuah. 2010 Aug;149(8):494-7, 552.
Osteoid osteoma (OO) is a benign osteoblastic bone lesion that causes severe local pain mainly at night, and usually responds to oral administration of NSAID. The lesion is located around the proximal thigh in more than 50% of the cases. Osteoblastoma is similar to OO in their histopathology features, but emerges frequently in the spine, and has a larger diameter than OO. Percutaneous CT-guided radiofrequency ablation (RFA) is becoming the treatment of choice for osteoid osteoma and non-aggressive osteoblastoma in the last decade.
During the period 2005-2009, 38 patients were diagnosed with osteoid osteoma (n = 34), and osteoblastoma (n = 4). A total of 34 patients were treated with RFA using a water-cooled, variable ablation size tip. Two patients underwent an open procedure, and 2 had spontaneous remission.
Thirty three patients (97%) reported complete remission of their pain after a single treatment; one patient needed a second RFA treatment, and reported full remission of his symptoms after the 2nd treatment.
Percutaneous CT-guided radiofrequency ablation of osteoid osteoma and non-aggressive osteoblastoma is simple, safe, and reliable. Meticulous placement of the probe inside the tumor, and the usage of water-cooled, variable ablation size tip, improves the overall outcome and decrease complication rates.
骨样骨瘤(OO)是一种良性成骨性骨病变,主要在夜间引起严重的局部疼痛,通常对口服非甾体抗炎药有反应。超过50%的病例中病变位于大腿近端周围。骨母细胞瘤在组织病理学特征上与骨样骨瘤相似,但常在脊柱中出现,且直径比骨样骨瘤大。在过去十年中,经皮CT引导下射频消融(RFA)正成为骨样骨瘤和非侵袭性骨母细胞瘤的首选治疗方法。
在2005年至2009年期间,38例患者被诊断为骨样骨瘤(n = 34)和骨母细胞瘤(n = 4)。共有34例患者使用水冷式、可变消融尺寸的电极尖端接受了RFA治疗。2例患者接受了开放手术,2例自发缓解。
33例患者(97%)在单次治疗后报告疼痛完全缓解;1例患者需要进行第二次RFA治疗,并在第二次治疗后报告症状完全缓解。
经皮CT引导下对骨样骨瘤和非侵袭性骨母细胞瘤进行射频消融简单、安全且可靠。将探头精确放置在肿瘤内部,以及使用水冷式、可变消融尺寸的电极尖端,可改善总体疗效并降低并发症发生率。