Percutaneous excision of difficult osteoid osteomas using intraoperative AIRO CT navigation: a preliminary report

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Oncology

Background:

• Osteoid osteomas present challenges in surgical localization and complete removal, particularly when not visible on plain radiographs.
• Current localization methods involving radiology suites and operating rooms can be cumbersome and prone to errors due to lack of real-time imaging.

Purpose of the Study:

• To describe and evaluate a technique using intraoperative computed tomography (CT) navigation for the precise localization and excision of osteoid osteomas.
• To assess the safety, efficacy, and minimally invasive nature of this navigation-assisted approach.

Main Methods:

• A technique employing intraoperative CT navigation was utilized for six patients with osteoid osteomas.
• Lesions were localized using AIRO software, and excision was performed with a high-speed burr.
• Postexcision on-table CT scans confirmed complete nidus removal.

Main Results:

• All six patients achieved complete excision of the osteoid osteoma nidus, confirmed by intraoperative CT.
• All patients experienced symptom resolution and were doing well at a minimum 6-month follow-up.
• The technique proved safe, effective, and minimally invasive.

Conclusions:

• Intraoperative CT navigation is a valuable tool for accurately localizing osteoid osteomas and confirming complete excision.
• This method is particularly beneficial for lesions that are difficult to visualize or access with conventional C-arm guidance.
• The described technique represents a safe, effective, and minimally invasive treatment option for osteoid osteomas.