[CT-controlled thermocoagulation of osteoid osteoma in comparison with traditional methods]

What are the advantages of CT-guided radiofrequency ablation in comparison to traditional techniques?

91 patients with Osteoid Osteoma were analyzed. 15 patients were treated by a wide excision removing a bone block. 26 patients had a marginal resection removing the entire nidus. 36 patients had intralesional margins by curettage or high speed burr technique. Four patients were treated percutaneously by CT-guided drilling technique. 10 patients were treated with the new CT-guided radiofrequency ablation technique.

Patients treated by a wide excisional margin had an average procedural length of 2 hours 45 minutes and an average hospital stay of 5 days. Cost figures totaled $13,826. One patient in this group required a bone graft. All patients had a non weight bearing status for six weeks and were limited for ten weeks on average. After marginal resections procedure length was 3 hours. Patients required an hospital stay of 3 days and cost data showed an amount of $10,857.28. 2 patients requiring bone grafts. All patients required post op casting, crutches or braces. Intralesional resection showed a procedure length of 2 hours 40 minutes with an hospital stay of 5 days. Cost figures showed an amount of $10,992. Recovery time was on average of 7 weeks. A cast was applied to three patients post op and one patient did require bone grafting due to the resulting defect. The percutaneous CT-guided burr ablation technique took 2 1/2 hours and the patients required overnight hospital stays for pain control. The costs added to $8589.80. One patient developed a non displaced fracture. For the new CT-guided Radiofrequency ablation technique the average time was 2 hours 10 minutes. Only one patient required an overnight hospital stay. Average total costs for these patients were $6583.66. 1 week post procedure all patients were free of symptoms and resumed full weight bearing. There has been no evidence of recurrence and all patients were symptom free at last contact.

CT-guided radiofrequency ablation allows the orthopaedic surgeon to heal osteoid osteoma with minimal trauma, functional restrictions and costs.