Wang Tian-Long, Luo Yi-Ping, Zhou Zi-Fei, Liu Jun-Feng, Hou Xiao-Dong, Jia Shao-Hua, Zheng Long-Po
Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Surg. 2022 May 2;9:881852. doi: 10.3389/fsurg.2022.881852. eCollection 2022.
Osteoid osteoma is a common benign bone tumor, and clinically there is severe local pain that typically worsens at night. The conventional CT-guided radiofrequency ablation (RFA) was widely used in the treatment of osteoid osteoma (OO), which could result in some radiation-related and imprecise complications due to the overdose of radiation exposure. This study aimed to compare the surgical effect of robot-assisted RFA with O-arm navigation and conventional CT-guided RFA in the treatment of OO.
Sixty-two patients who underwent robot-assisted RFA with O-arm navigation (Robot-RFA, = 24) or CT-guided RFA (CT-RFA, = 38) were included in this retrospective cohort study. The mean follow-up time was 23.3 months. The intra-operative data, primary technical success rate, visual analog scale (VAS), and post-operative complications were analyzed.
Primary technical success was obtained in 23 patients who had robot-assisted RFA, and 35 patients who had conventional CT-guided RFA. One patient in Robot-RFA group and three patients in CT-RFA group with pain recurrence received repeat-RFA and had a secondary success. Mean operation time and dose of radiation exposure were lower in Robot-RFA group than that in CT-RFA group. The Robot-RFA group took fewer K-wire adjustment times for each patient than the CT-RFA group. There was a statistically significant difference in the mean operation time, dose of radiation exposure, and K-wire adjustment times between the groups ( < 0.05). No complications associated with the procedure were reported in the two groups during the follow-up period.
Robot-assisted RFA with O-arm navigation is a safer and more precise strategy in the treatment of osteoid osteoma with less operation time and radiation exposure compared with the conventional CT-guided radiofrequency ablation.
骨样骨瘤是一种常见的良性骨肿瘤，临床上存在严重的局部疼痛，通常在夜间加重。传统的CT引导下射频消融术（RFA）广泛应用于骨样骨瘤（OO）的治疗，但由于辐射暴露过量，可能导致一些与辐射相关的不精确并发症。本研究旨在比较机器人辅助O型臂导航RFA与传统CT引导RFA治疗OO的手术效果。
本回顾性队列研究纳入了62例行机器人辅助O型臂导航RFA（机器人RFA组，n = 24）或CT引导RFA（CT-RFA组，n = 38）的患者。平均随访时间为23.3个月。分析术中数据、主要技术成功率、视觉模拟评分（VAS）和术后并发症。
23例行机器人辅助RFA的患者和35例行传统CT引导RFA的患者获得了主要技术成功。机器人RFA组1例患者和CT-RFA组3例疼痛复发患者接受了重复RFA并获得了二次成功。机器人RFA组的平均手术时间和辐射暴露剂量低于CT-RFA组。机器人RFA组每位患者的克氏针调整次数少于CT-RFA组。两组之间的平均手术时间、辐射暴露剂量和克氏针调整次数存在统计学显著差异（P < 0.05）。随访期间两组均未报告与手术相关的并发症。
与传统CT引导下射频消融相比，机器人辅助O型臂导航RFA治疗骨样骨瘤是一种更安全、更精确的策略，手术时间和辐射暴露更少。
