Modified thermal modulation for safe radiofrequency ablation of spinal osteoid osteoma: a pilot study

In our pilot study, we modified the temperature and duration of radiofrequency ablation of spinal osteoid osteoma to minimize the risk of neural damage without compromising adequate ablation.

Seven patients were enrolled in this study after obtaining written informed consent. RFA was done in prone position under CT-guidance (256-slice Siemens Somatom scanner) under general anesthesia. Additional neuroprotection was provided in form of pneumo-dissection and hydro-dissection into epidural space via entry from a contralateral inter-laminar space. Ablation was done using RITA XL-Starburst ™ multi-tined probe as a component of Angiodynamics monopolar RF ablation system. Stepwise graded increase in temperature was performed in three phases (Induction, Amplification and Residual burn). Post operative evaluation was done using VAS and four hourly sensory and motor examinations. Clinical success was defined as post-operative day 1 VAS of ≤ 3. Follow up was done at 1 month,3 months and 6 months and neurological status was evaluated at all follow ups.

We evaluated a novel technique of ablation using graded thermal modulation in seven patients of spinal osteoid osteoma without any adverse injuries or sensory-motor neurological deficits. All seven patients fulfilled the criteria of technical and clinical success and demonstrated a significant reduction in VAS on the first post-operative day with no residual symptoms on serial follow ups.

Modified RFA using graded thermal modulation has shown promising result for safe ablation of spinal osteoid osteoma in our pilot study.