CT-guided radiofrequency ablation of osteoid osteoma using a novel battery-powered drill

To evaluate the use of a novel battery-powered drill, enabling specimen requirement while drilling, in radiofrequency ablation of osteoid osteoma as an alternative to conventional orthopedic drills.

Between 2009 and 2013, altogether 33 patients underwent CT-guided radiofrequency ablation of an osteoid osteoma at our institution. To access the nidus of the clinically and radiologically suspected osteoid osteoma, a channel was drilled using the OnControl Bone Marrow Biopsy System (OBM, Arrow OnControl, Teleflex, Shavano Park, TX, USA) and a biopsy was taken. Procedure time (i.e., drilling including local anesthesia), amount of scans (i.e., single-shot fluoroscopy), radiation exposure, and the results of biopsy were investigated and compared retrospectively to a classical approach using either a manual bone biopsy system or a conventional orthopedic drill (n = 10) after ethical review board approval.

Drilling the tract into the nidus was performed without problems in 22 of the 23 OBM cases. Median procedure time was 7 min compared to 13 min using the classical approach (p < 0.001). Median amount CT scans, performed to control correct positioning of the drill was comparable with 26 compared to 24.5 (p = NS) scans. Histologically, the diagnosis of osteoid osteomas could be determined in all 17 cases where a biopsy was taken. Radiofrequency ablation could be performed without problems in any case.

The use of the battery-powered drill was feasible and facilitated the access to the osteoid osteoma's nidus offering the possibility to extract a specimen in the same step.