Shu Man, Ke Jin
Department of Orthopaedics, General Hospital of Southern Theater Command, Southern Medical University, Guangzhou, China.
Department of Orthopaedics, ZhuJiang Hospital of Southern Medical University, Southern Medical University, Guangzhou, China.
Front Oncol. 2022 Jul 22;12:935640. doi: 10.3389/fonc.2022.935640. eCollection 2022.
Osteoid osteoma (OO) comprises approximately 11%-14% of benign bone tumors. The main symptom of OO is localized pain accompanied by nighttime aggravation. Surgical treatment is frequently used in clinic, including open surgery and percutaneous ablation, the latter including radiofrequency ablation, cryoablation, and microwave ablation, but there is no consensus on when and how to choose the best treatment for OO.
We did a systematic review of the literature on existing surgical treatments of OO to assess the safety and efficacy of surgical treatments of OO and to evaluate the surgical options for different locations of OO.
The inclusion criteria in the literature are 1. Patients diagnosed with osteoid osteoma and treated surgically; 2. Include at least five patients; 3. Perioperative visual analogue scale (VAS), postoperative complications, and recurrence were recorded; 4. Literature available in PubMed from January 2014 to December 2021.
In the cohort, 1565 patients (mainly adolescents) with OO received 1615 treatments. And there are 70 patients with postoperative recurrence and 93 patients with postoperative complications (minor: major=84:9). The results of Kruskal-Wallis examination of each experimental index in this experiment were clinical success rate H=14.818, p=0.002, postoperative short-term VAS score H=212.858, p<0.001, postoperative long-term VAS score H=122.290, p<0.001, complication rate H=102.799, p<0.001, recurrence rate H=17.655, p<0.001, the technical success rate was H=45.708, p<0.001, according to the test criteria of α=0.05, H was rejected. The overall means of the outcome index in each group were not completely equal.
Percutaneous ablation and open surgery are safe and reliable for OOs, and the technical success rate of percutaneous ablation is higher than that of open surgery. Open surgery and cryoablation can be selected for OOs close to the nerve and atypical sites, while radiofrequency ablation and microwave ablation can be selected for OOs in most other sites.
骨样骨瘤（OO）约占良性骨肿瘤的11%-14%。骨样骨瘤的主要症状是局部疼痛，夜间加重。临床上常用手术治疗，包括开放手术和经皮消融，后者包括射频消融、冷冻消融和微波消融，但对于何时以及如何选择骨样骨瘤的最佳治疗方法尚无共识。
我们对现有骨样骨瘤手术治疗的文献进行了系统综述，以评估骨样骨瘤手术治疗的安全性和有效性，并评估不同部位骨样骨瘤的手术选择。
文献纳入标准为：1. 诊断为骨样骨瘤并接受手术治疗的患者；2. 至少包括5例患者；3. 记录围手术期视觉模拟评分（VAS）、术后并发症和复发情况；4. 2014年1月至2021年12月在PubMed上可获取的文献。
在该队列中，1565例骨样骨瘤患者（主要为青少年）接受了1615次治疗。术后复发70例，术后并发症93例（轻微：严重=84:9）。本实验各实验指标的Kruskal-Wallis检验结果为临床成功率H=14.818，p=0.002，术后短期VAS评分H=212.858，p<0.001，术后长期VAS评分H=122.290，p<0.001，并发症发生率H=102.799，p<0.001，复发率H=17.655，p<0.001，技术成功率H=45.708，p<0.001，根据α=0.05的检验标准，拒绝H。每组结局指标的总体均值不完全相等。
经皮消融和开放手术治疗骨样骨瘤安全可靠，经皮消融的技术成功率高于开放手术。靠近神经和非典型部位的骨样骨瘤可选择开放手术和冷冻消融，而大多数其他部位的骨样骨瘤可选择射频消融和微波消融。
