Gangi A, Dietemann J L, Gasser B, Mortazavi R, Brunner P, Mourou M Y, Dosch J C, Durckel J, Marescaux J, Roy C
Department of Radiology, University Hospital of Strasbourg, France.
Radiology. 1997 Jun;203(3):843-8. doi: 10.1148/radiology.203.3.9169714.
To evaluate interstitial laser photocoagulation (a minimally invasive percutaneous technique of thermal destruction of deep-seated tumors, with low-power laser energy) in local destruction of osteoid osteoma, with computed tomographic (CT) guidance.
Fifteen patients (age range, 8-48 years) with presumed osteoid osteoma were treated with CT-guided interstitial laser photocoagulation of the nidus. A high-power semiconductor diode laser (805 nm) with a 400-microm optical fiber was used. The fiber was introduced into the nidus through an 18-gauge needle. Around the fiber tip, well-defined coagulative necroses from 5 to 9 mm (energy delivery, 400-1,000 J) were obtained.
Fourteen patients had complete pain relief, which was apparent within 24 hours in eight patients. One patient had recurrence of pain after 6 weeks. The remaining nidus was treated a second time, with complete relief. Treatment was unsuccessful in one patient, and surgical excision was performed. Daily activities were not restricted after the intervention. All patients were followed up for more than 1 year, with no sign of recurrence. The only notable complication was a mild reflex sympathetic dystrophy of the wrist in one patient. Sclerosis of the nidus was observed 4-6 months after the procedure.
Percutaneous interstitial laser photocoagulation of osteoid osteoma seems to be a promising, simple, precise, and minimally invasive alternative to traditional surgical and percutaneous ablations.
在计算机断层扫描（CT）引导下，评估间质激光光凝术（一种利用低功率激光能量对深部肿瘤进行热破坏的微创经皮技术）对骨样骨瘤的局部破坏效果。
15例疑似骨样骨瘤患者（年龄范围8 - 48岁）接受了CT引导下对瘤巢的间质激光光凝治疗。使用了带有400微米光纤的高功率半导体二极管激光（805纳米）。通过18号针将光纤插入瘤巢。在光纤尖端周围，形成了清晰界定的5至9毫米的凝固性坏死灶（能量传递400 - 1000焦耳）。
14例患者疼痛完全缓解，其中8例在24小时内疼痛明显缓解。1例患者在6周后疼痛复发，对剩余瘤巢进行了二次治疗，疼痛完全缓解。1例患者治疗失败，接受了手术切除。干预后日常活动不受限制。所有患者均随访超过1年，无复发迹象。唯一明显的并发症是1例患者出现轻度腕部反射性交感神经营养不良。术后4 - 6个月观察到瘤巢硬化。
经皮间质激光光凝治疗骨样骨瘤似乎是一种有前景的、简单、精确且微创的替代传统手术和经皮消融的方法。
