Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Medicine (Baltimore). 2023 Dec 22;102(51):e36747. doi: 10.1097/MD.0000000000036747.
Recently, cone-beam computed tomography (CBCT)-guided surgeries have been developed for bone and soft tissue tumors. The present study aimed to evaluate the efficacy of CBCT-guided curettage for osteoid osteoma. Our study population included 13 patients who underwent primary curettage for osteoid osteoma using intraoperative CBCT in a hybrid operating room between April 2019 and November 2022. We collected the following data: sex, age, follow-up period, symptom onset to time of surgery, tumor size and location, length of skin incision, operating time, radiation dose, recurrence, postoperative complications, and visual analog scale for pain during the last follow-up. There were 10 male and 3 female patients, and the mean age was 25.0 years (range, 9-49 years). The mean follow-up period was 10.6 months (range, 0.4-24.0 months). The locations of the tumors were the proximal femur in 6 patients, the acetabular region in 2 patients, and the ilium, tibial shaft, calcaneus, cuboid, and talus in 1 patient each. The mean time of symptoms onset to surgery was 18.7 months (range, 2.3-69.9 months). The mean maximum diameter of the tumor was 5.9 mm (range, 3.5-10.0 mm). The mean length of the skin incision was 2.2 cm (range, 1.5-3.5 cm). The mean operating time was 96.9 minutes (range, 64-157 minutes). The mean dose of radiation was 193.2 mGy (range, 16.3-484.0 mGy). No recurrences, postoperative complications, and reoperation were observed in this study. All the patients reported 0 mm on the visual analogue scale for pain on the last follow-up. CBCT-guided curettage for osteoid osteoma was minimally invasive and reliable. This procedure can be effective for the treatment of lesions found in deep locations such as the pelvic bone and proximal femur or an invisible lesion that cannot be detected by regular fluoroscopy.
最近，基于锥形束 CT（CBCT）的手术已经应用于骨和软组织肿瘤。本研究旨在评估 CBCT 引导下刮除术治疗骨样骨瘤的疗效。我们的研究对象包括 13 名患者，他们于 2019 年 4 月至 2022 年 11 月在混合手术室中接受了术中 CBCT 引导下的原发性刮除术。我们收集了以下数据：性别、年龄、随访时间、症状出现到手术时间、肿瘤大小和位置、皮肤切口长度、手术时间、辐射剂量、复发、术后并发症以及末次随访时的疼痛视觉模拟评分。患者中男 10 例，女 3 例，平均年龄 25.0 岁（9-49 岁）。平均随访时间为 10.6 个月（0.4-24.0 个月）。肿瘤位置：股骨近端 6 例，髋臼区 2 例，髂骨、胫骨骨干、跟骨、骰骨和距骨各 1 例。症状出现到手术的平均时间为 18.7 个月（2.3-69.9 个月）。肿瘤最大直径的平均直径为 5.9mm（3.5-10.0mm）。皮肤切口的平均长度为 2.2cm（1.5-3.5cm）。平均手术时间为 96.9 分钟（64-157 分钟）。平均辐射剂量为 193.2mGy（16.3-484.0mGy）。本研究未观察到复发、术后并发症和再次手术。末次随访时，所有患者疼痛视觉模拟评分均为 0mm。CBCT 引导下刮除术治疗骨样骨瘤具有微创、可靠的优点。该手术可有效治疗骨盆和股骨近端等深部位置或常规透视无法发现的隐匿性病变。
