Manisa Celal Bayar University Medicine Faculty, Radiology Department, Manisa, Turkey.
Manisa Celal Bayar University Medicine Faculty, Orthopaedics and Traumatology Department, Manisa, Turkey.
Curr Med Imaging. 2024;20:e270623218293. doi: 10.2174/1573405620666230627095757.
Osteoid osteoma (OO) is a painful benign bone tumor. Typically, it causes pain that is most noticeable during the night, which is improved by nonsteroidal anti-inflammatory drugs. In the treatment of symptomatic lesions, open surgery for nidus removal is the gold standard. However, surgical technical difficulties and morbidities vary by location. Percutaneous radiofrequency ablation (RFA) therapy guided by computed tomography (CT) is now a popular treatment option for OO. This study aims to assess our single-center experience with the technique, complications, and procedure effectiveness.
The study included fifteen patients who were treated between 2017 and 2021. A retrospective analysis was carried out on archive images and file records. The lesions' location, nidus width, and affected area (cortical, medullary) were all recorded. The procedure and technical success, as well as postoperative complications and the need for repeat ablation, were all documented.
A total of 20 patients, 18 men, and 2 women, were included in the study, and 12 of them were pediatric patients. The patients' mean age was 16.9±7.3 years old, and the mean nidus diameter was 7.1±8.7 mm. There were 13 cortical niduses, 2 intramedullary niduses, and 5 corticomedullary niduses. The lesions were in the femur (n=12), tibia (n=6), scapula (n=1), and vertebrae (n=1). Two recurrences (10%) were observed in our patients during the follow-up. Patient with a femoral OO, the pain started again 12 weeks after the procedure and we performed additional RFA. The patient with vertebral OO had fewer symptoms and full recovery was not achieved. Therefore, the vertebral OO was ablated again 4 months later, and clinical success was achieved. One patient had a minor burn at the entry site that went away on its own after a short period of time. Except for the patient who was scheduled for a repeat RFA, no recurrence has been observed so far. The primary and secondary success rates are, respectively, 90% (18/20) and 100% (20/20).
RFA has a high success rate in treating OO. The procedure failure and recurrence rates are low. There are possibilities for posttreatment pain relief, early discharge, and a quick return to daily life. For inappropriate lesion localization, the RFA process replaces surgical treatment. The procedurerelated complication rate is low. On the other hand, the burn during the procedure can be a serious problem.
骨样骨瘤（OO）是一种疼痛性良性骨肿瘤。通常，它会引起夜间最明显的疼痛，而非甾体抗炎药可缓解疼痛。在治疗有症状的病变时，病灶切除术的开放性手术是金标准。然而，手术的技术难度和发病率因位置而异。计算机断层扫描（CT）引导下的经皮射频消融（RFA）治疗现在是 OO 的一种流行治疗选择。本研究旨在评估我们单中心使用该技术的经验、并发症和程序效果。
研究纳入了 2017 年至 2021 年间接受治疗的 15 名患者。对存档图像和文件记录进行回顾性分析。记录病变位置、病灶宽度和受累区域（皮质、髓质）。记录手术和技术成功率、术后并发症以及是否需要重复消融。
本研究共纳入 20 名患者，其中 18 名男性和 2 名女性，12 名患者为儿童。患者的平均年龄为 16.9±7.3 岁，平均病灶直径为 7.1±8.7mm。13 例为皮质病灶，2 例为髓内病灶，5 例为皮质髓腔病灶。病变位于股骨（n=12）、胫骨（n=6）、肩胛骨（n=1）和椎体（n=1）。在我们的患者中观察到 2 例（10%）复发。股骨 OO 患者术后 12 周再次出现疼痛，我们再次进行了 RFA。患有椎体 OO 的患者症状较少，未完全恢复。因此，4 个月后再次对椎体 OO 进行消融，获得了临床成功。1 例患者在入路处有轻微烧伤，短时间后自行消退。除了计划再次进行 RFA 的患者外，目前尚未观察到复发。原发性和继发性成功率分别为 90%（18/20）和 100%（20/20）。
RFA 治疗 OO 的成功率高。手术失败和复发率低。术后疼痛缓解、早期出院和快速恢复日常生活的可能性较大。对于不合适的病变定位，RFA 过程可替代手术治疗。与该过程相关的并发症发生率较低。另一方面，手术过程中的烧伤可能是一个严重的问题。
