Percutaneous plasma mediated radiofrequency ablation of spinal osteoid osteomas

Plasma mediated radiofrequency ablation (pmRFA) may allow for the percutaneous treatment of spinal tumors with a decreased risk of thermal injury to neural structures compared with traditional (radiofrequency or interstitial laser) ablation. However, usage of pmRFA has not been previously reported for a primary bone tumor, including an osteoid osteoma. Three patients with a spinal osteoid osteoma underwent pmRFA. The procedure was performed under computed tomography guidance using the 11 gauge Coblation SpineWand (ArthroCare). One lesion (at T11) was directly abutting the spinal canal. With an average follow-up of 20.7 (range 16-24) months, the mean Visual Analog Scale score for back pain decreased from 8.67 to 0.67 and no patient experienced tumor recurrence. pmRFA of spinal osteoid osteomas is feasible, even when the tumor is abutting the spinal canal. Larger studies with a longer follow-up are needed to further delineate the safety and efficacy of this technique.