Gangi A, Dietemann J L, Guth S, Vinclair L, Sibilia J, Mortazavi R, Steib J P, Roy C
Department of Radiology, University Hospital of Strasbourg, France.
AJNR Am J Neuroradiol. 1998 Nov-Dec;19(10):1955-8.
Spinal osteoid osteomas are rare; when they occur, they are usually treated by surgical or percutaneous excision. The aim of percutaneous interstitial laser photocoagulation (ILP) of osteoid osteomas under CT guidance is thermal destruction of the nidus using low-power laser energy, thus precluding bone resection and open surgery.
Three cases of spinal osteoid osteomas were treated with percutaneous ILP of the nidus. Under CT guidance, the needle was positioned in the center of the nidus, at least 8 mm from neurologic structures. Using a high-power semiconductor diode laser (805 nm) with a 400-microm optical fiber, we delivered 600 to 800 joules to the nidus, depending on its size. The procedure was performed with the patient under neuroleptanalgesia and required overnight hospitalization.
Complete pain relief was obtained in all three patients within 24 hours of the procedure, and no major complications were incurred. Follow-up ranged from 20 months to 60 months.
Percutaneous ILP of spinal osteoid osteoma is a promising, simple, precise, and minimally invasive technique and may be an alternative to traditional surgical and percutaneous ablations.
脊柱骨样骨瘤较为罕见；一旦发生，通常采用手术或经皮切除治疗。在CT引导下对骨样骨瘤进行经皮间质激光光凝（ILP）的目的是使用低功率激光能量对瘤巢进行热破坏，从而避免骨切除和开放手术。
对3例脊柱骨样骨瘤患者进行了瘤巢的经皮ILP治疗。在CT引导下，将针置于瘤巢中心，距神经结构至少8mm。使用带有400微米光纤的高功率半导体二极管激光（805nm），根据瘤巢大小向其输送600至800焦耳能量。该操作在患者处于神经安定镇痛状态下进行，且患者需要住院过夜。
所有3例患者在术后24小时内疼痛完全缓解，未发生重大并发症。随访时间为20个月至60个月。
经皮ILP治疗脊柱骨样骨瘤是一种有前景、简单、精确且微创的技术，可能是传统手术和经皮消融的替代方法。
