Percutaneous destruction and alcoholisation for the management of osteoid osteoma

Osteoid osteoma (OO) is a small, self-limiting, benign osteogenic tumour. Successful treatment of OO requires complete resection or destruction of the nidus. Surgery, which consists of en bloc excision of the nidus, followed by internal fixation, bone grafting, or both, is successful in almost all cases. In a small percentage of cases the nidus may be missed at surgery, resulting in a failed procedure. The aim of this study was to evaluate the results of percutaneous destruction and alcoholisation as a treatment of OO. Fifteen patients with an osteoid osteoma (10 males, 5 females) were treated in the Oncology Unit, Orthopaedic Department, Mansoura University Hospital. Three OOs were localised in the humerus, 5 in the femur, 6 in the tibia and fibula, and one in the talus. All patients underwent destruction of the nidus by determining the nidus by CT, drilling with a cannulated drill bit, curretting with a speed burr and injecting ethanol. The nidus completely disappeared on the postoperative CT-scan. The average follow-up period was 19 months (6-24 months). There were no postoperative complications. This technique for the treatment of OO is minimally invasive, safe, simple, and cost effective. It allows an early return to normal activities. The procedure is particularly useful for a lesion located deep in the skeleton, which would require an extensive approach with conventional surgery.