Medical management compared with operative treatment for osteoid-osteoma.

Kneisl, Jeffrey S.; Simón, M. Angustias Quesada

doi:10.2106/00004623-199274020-00004

Cited by 345 publications

(168 citation statements)

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“…If symptoms persist, initial treatment usually consists of a trial of medical therapy using aspirin or other NSAIDs. With regards to medical treatment, long-term medication is needed and symptoms may recur after the discontinuation of medication [2,9]. With increasing pain and associated insomnia, many seek definitive treatment traditionally achieved by surgical resection [4].…”

Section: Discussionmentioning

confidence: 99%

Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma—2 to 5 years follow-up

Sung

Seo

Shim

et al. 2007

International Orthopaedics (SICO

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The purpose of this study is to evaluate the efficacy of the computed tomography (CT)-guided percutaneous radiofrequency thermoablation (PRT) method with a minimum of 2 years follow-up. Twenty-eight patients who were followed for more than 2 years among 35 patients who underwent CT-guided PRT between April 1999 and May 2005 were included in this study. The mean age was 24.5 years (range 7-55 years) and the mean follow-up period was 40.1 months (range 24-66 months). With a radiofrequency electrode, the lesion was heated to 80°C or 90°C for 6.5 mins (range 3-9 mins). Clinical success was assessed at the out-patient clinic by symptoms and radiographs. Twenty-six patients (90%) experienced a total loss of symptoms and additional PRT also relieved the ongoing symptoms in all of the recurrent patients. PRT appears to be a safe and effective method for treating osteoid osteoma and is also effective in recurrent cases. This treatment modality is a minimally invasive procedure and is a good alternative to open surgical treatment.Résumé Le propos de cette étude est d'évaluer l'efficacité de cette méthode avec un minimum de deux ans de recul. 28 patients ont été suivis pendant deux ans parmi 35 patients ayant bénéficié entre avril 99 et mai 2005 d'une ablation d'ostéome ostéoide par radio fréquence, guidée sous scanner. L'âge moyen était de 24,5 ans (7 à 55) et le suivi moyen de 40,1 mois (24 à 66). L'électrode permet de chauffer la lésion de 80 à 90°C en moyenne pendant 6,5 minutes (de 3 à 9). 90% des patients (26 à 28) ont pu, grâce à cette méthode, avoir une disparition totale des symptômes et pour ceux qui gardaient une symptomatologie persistante ou récurrente, un geste complémentaire de thermo régulation a été réalisé. Cette méthode apparaît comme une méthode sûre et efficace dans le traitement des ostéomes ostéoides et également dans les récidives. Ce traitement est un traitement mini invasif tout a fait alternatif avec le traitement par voie chirurgicale sanglante.

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Section: Discussionmentioning

confidence: 99%

Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma—2 to 5 years follow-up

Sung

Seo

Shim

et al. 2007

International Orthopaedics (SICO

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“…The first description of the pathology of osteoid osteoma is attributed to Bergstrand by Kneisl and Simon [10]. Jaffe reported five cases in 1935 [8].…”

Section: Discussionmentioning

confidence: 99%

High-frequency radio-wave ablation of osteoid osteoma in the lumbar spine

Osti

Sebben²

1998

European Spine Journal

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A 24-year-old physical education teacher presented with a 1-year history of disabling left-sided low back pain with intermittent irradiation to the left thigh. No previous history of trauma or other cause for the onset of symptoms was reported. The patient's past history was unremarkable. He had initially sought conservative treatment through physiotherapy and chiropractic manipulation and had required daily analgesia with no significant benefit.Over the 6 weeks preceding the assessment by the senior author (O.L.O.), he had been unable to work because of further deterioration of his back symptoms. On examination a mild right lumbar scoliosis was noted which was not fully correctible in lateral bending. There was marked tenderness over the left L3-4 apophyseal joint with moderate restriction of lumbar movement, both in flexion and extension. Straight leg raising was unrestricted and there was no evidence of neurological involvement in the lower limbs. The patient denied any specific difficulties of bladder or bowel function.Imaging included plain radiographs, a bone scan with SPECT, and a CT scan (Figs. 1-3).The procedure was carried out using neuroleptic anaesthesia (midazolam and fentanyl) supplemented by local infiltration with lignocaine and bupivacaine. The patient was positioned prone in the CT scanner (Toshiba Express SX).A core biopsy of the lesion was then carried out using a Cook trephine needle (Cook Bone Biopsy Set, Cook, Australia) (Fig. 4), which was followed by radio-wave ablation using a radio-frequency generator (Radionics RFG-6) with a 1-mm electrode at 85°C for 4 min. The electrode was introduced percutaneously through a 2-mm guiding cannula and positioned into the nidus. The cannula insulates the electrode throughout its length except for the terminal 5 mm.The patient was discharged from hospital 2 h after the procedure and reviewed at 6 weeks, 3 months and 16 months later. Relief of preoperative pain was reported 24 h after the operation. Two weeks later the patient was able to return to work as a physical education teacher in a full-time capacity with no restrictions. Histopathology confirmed the diagnosis of an osteoid osteoma (Fig. 5).At the 16-month follow-up, clinical examination revealed full and pain-free lumbar range of movement with no localised tenderness. There was no evidence of neurological deficit in the lower limbs.Imaging carried out at that stage demonstrated residual thickening of the left L4 neural arch, but with no evidence of recurrent or residual nidus (Fig. 6). AbstractThe authors report on the first known application in the spine of percutaneous ablation of osteoid osteoma using radio-frequency waves. The technique involves a CTguided biopsy of the lesion followed by introduction of a 1-mm probe connected to a radio-frequency lesion generator. The procedure was performed on an outpatient basis and the patient experienced immediate relief of his symptoms. No evidence of recurrence was demonstrated 16 months later. The techniqe described may become the procedure of choic...

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“…4 -7 Traditional treatment of patients with osteoid osteoma consisted of a trial of medical therapy using aspirin or nonsteroidal anti-inflammatory medications, together with surgical excision of the nidus of the tumour. 8,9 However, operative treatment of intra-articular osteoid osteomas of the hip may require prophylactic internal fixation and bone grafting, and can result in prolonged hospitalization, joint stiffness and PJ Papagelopoulos, AF Mavrogenis, CK Kyriakopoulos et al…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation of Intra-articular Osteoid Osteoma of the Hip

et al. 2006

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Diagnosis and treatment of intra-articular osteoid osteoma is challenging. We present 16 patients with intra-articular osteoid osteomas of the hip treated with percutaneous radiofrequency ablation. Eight osteoid osteomas were located in the femoral head, six in the femoral neck, and two in the acetabulum. Three of the 16 patients had had an incorrect previous diagnosis. Percutaneous radiofrequency ablation was a clinical and technical success in all 16 patients. Within the first 24 h after the procedure, pain improved in all patients. Five patients had pain relief within the first 3 days after the procedure, nine patients within the first week and two patients within 2 weeks. Residual or recurrent symptoms were not reported by the last follow-up. At the 12-month follow-up, computed tomography and magnetic resonance imaging showed complete ossification and bone regeneration at the site of the lesion in three patients, partial ossification in six patients and no changes in seven patients. Computed tomography-guided percutaneous radiofrequency ablation is a simple, minimally invasive, safe and effective method for the treatment of most intra-articular osteoid osteomas.

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Medical management compared with operative treatment for osteoid-osteoma.

Cited by 345 publications

References 0 publications

Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma—2 to 5 years follow-up

Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma—2 to 5 years follow-up

High-frequency radio-wave ablation of osteoid osteoma in the lumbar spine

Radiofrequency Ablation of Intra-articular Osteoid Osteoma of the Hip

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