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Radiofrequency ablation of spinal osteoid osteoma: clinical outcome
Geert M Vanderschueren1, Wim R Obermann, Sander P D Dijkstra
1Department of Radiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
Study Design:
A prospective study on 24 patients with spinal osteoid osteoma treated with radiofrequency ablation (RFA).
Objective:
To determine if and when computed tomography (CT)-guided RFA is a safe and effective treatment for spinal osteoid osteomas.
Summary Of Background Data:
Surgery has been considered the standard treatment for spinal osteoid osteomas. Surgery may cause spinal instability, infection, and nervous injury. We evaluated CT-guided RFA as an alternative treatment.
Methods:
A total of 28 RFA procedures in 24 patients with spinal osteoid osteoma were performed, using a 5-mm noncooled electrode. Clinical symptoms and spinal deformity were evaluated before and after the procedure. Unsuccessful treatment was defined as the presence of residual or recurrent symptoms. The mean follow-up was 72 months (range: 9-142 months).
Results:
Nineteen (79%) patients were successfully treated after 1 RFA, and all except one after repeat RFA. One patient with nerve root compression needed further surgery. No complications were observed. Spinal deformity persisted in 3 of 7 patients after successful RFA.
Conclusion:
CT-guided RFA is a safe and effective treatment for spinal osteoid osteoma. Surgery should be reserved for lesions causing nerve root compression.