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双周期射频消融技术治疗骨样骨瘤的长期临床疗效

Long-term clinical outcomes of dual-cycle radiofrequency ablation technique for treatment of osteoid osteoma.

作者信息

Abboud Salim, Kosmas Christos, Novak Ronald, Robbin Mark

机构信息

Department of Radiology, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.

出版信息

Skeletal Radiol. 2016 May;45(5):599-606. doi: 10.1007/s00256-015-2321-3. Epub 2016 Jan 21.

Abstract

PURPOSE

Radiofrequency ablation technique for treatment of OO including ablation time and temperature vary greatly between and within reported studies. This study evaluates the immediate and long-term efficacy and complication rate of a two sequential RFA technique for OO.

MATERIALS AND METHODS

We retrospectively reviewed medical records and attempted interview follow-up for 25 patients treated with RFA for OO. Each treatment included 2 consecutive RFAs at 90 °C for 6 min with inter-ablation cooling to 40 °C and occasional inter-ablation probe adjustment. Additionally, we statistically compared the proportion of successful ablations using the DCRFA technique with published studies that utilized alternative OO ablation procedures.

RESULTS

Long-term follow-up was obtained for 24 patients (96 %). Mean patient age at DCRFA was 17.2 years (range, 2.2-50.0 years). Mean time to follow-up was 60 ± 42 months (range 12-152 months). No acute DCRFA-related complications nor long-term recurrences were reported. All 24 interviewed patients reported partial relief of pre-procedural pain within 1 day of DCRFA and total relief within 1 week of DCRFA. One patient ultimately developed a major late complication (complex regional pain syndrome of the left ankle) after DCRFA of a cuboid lesion. Additionally, the DCRFA success rate was significantly higher when compared to two other published OO RFA treatment results.

CONCLUSION

DCRFA employing two sequential 6-min cycles is an effective treatment of OO. The 100 % primary success rate, 0 % long-term recurrence rate, and low complication rate compare favorably and may be superior to results of prior reports.

摘要

目的

用于治疗骨样骨瘤的射频消融技术,包括消融时间和温度,在已报道的研究之间和研究内部差异很大。本研究评估一种用于骨样骨瘤的两阶段连续射频消融技术的即刻和长期疗效及并发症发生率。

材料与方法

我们回顾性分析了25例接受射频消融治疗骨样骨瘤患者的病历,并尝试进行随访访谈。每次治疗包括在90℃下连续进行2次射频消融,每次6分钟,消融间期冷却至40℃,并偶尔调整消融探针。此外,我们将使用双周期连续射频消融技术(DCRFA)的成功消融比例与采用其他骨样骨瘤消融程序的已发表研究进行了统计学比较。

结果

对24例患者(96%)进行了长期随访。DCRFA时患者的平均年龄为17.2岁(范围2.2 - 50.0岁)。平均随访时间为60±42个月(范围12 - 152个月)。未报告与DCRFA相关的急性并发症和长期复发情况。所有24例接受访谈的患者均报告在DCRFA后1天内术前疼痛部分缓解,在DCRFA后1周内完全缓解。1例患者在骰骨病变进行DCRFA后最终出现了一种严重的晚期并发症(左踝复杂区域疼痛综合征)。此外,与其他两项已发表的骨样骨瘤射频消融治疗结果相比,DCRFA的成功率显著更高。

结论

采用两个连续6分钟周期的DCRFA是治疗骨样骨瘤的有效方法。100%的初次成功率、0%的长期复发率和低并发症发生率相比之下具有优势,可能优于先前报告的结果。

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