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Radiofrequency Ablation of Osteoid Osteoma with Use of Intraoperative Three-Dimensional Imaging and Surgical
Edward Y Cheng1, Sameer M Naranje1
1Department of Orthopaedic Surgery, University of Minnesota, 2512 South 7th Street, R 200, Minneapolis, MN 55454. E-mail address for E.Y. Cheng: cheng002@umn.edu.
Introduction:
During the performance of radiofrequency ablation of osteoid osteomas, the use of intraoperative cone-beam computed tomography (CT) imaging with surgical navigation lowers radiation exposure while allowing real-time targeting of the nidus.
Step 1 Preoperative Planning:
Review all images to confirm a high level of confidence in the radiographic diagnosis.
Step 2 Patient Positioning And Setup:
Be sure to position and set up properly.
Step 3 Placement Of Tracking Optical Array:
Attach the optical array to the target bone.
Step 4 O-Arm Setup Initial Ct Imaging For Surgical Navigation And Remote Mouse Registration:
Set up the intraoperative CT (O-Arm) machine and acquire the initial images for surgical navigation.
Step 5 Ct Data Interpretation And Approach Planning:
Analyze the initial images, rotated or positioned as necessary, to allow you to proceed with the planned direction and angle of approach to the nidus.
Step 6 Surgical Navigation Setup:
Register the surgical instruments with the surgical navigation unit.
Step 7 Nidus Localization And Kirschner Wire Insertion:
Target the nidus and then insert the Kirschner wire into its center.
Step 8 Exchanging Kirschner Wire For A Radiofrequency Probe:
Once the accuracy of the Kirschner wire placement is confirmed, exchange it for the radiofrequency probe and perform a CT scan to confirm proper probe placement.
Step 9 Confirmation Of Rfa Probe Placement:
Perform a CT scan to confirm proper placement of the probe within the center of the nidus.
Step 10 Activation Of The Radiofrequency Probe And Closure:
Perform the radiofrequency treatment to ablate the cells within the nidus.
Results:
We conducted a study of three different techniques of radiofrequency ablation.IndicationsContraindicationsPitfalls & Challenges.
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