Osteoid Osteoma

Donahue, F.; Ahmad, Adel; Mnaymneh, Walid; Pevsner, N. Henry

doi:10.1097/00003086-199909000-00025

Cited by 34 publications

(5 citation statements)

References 13 publications

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“…Percutaneous CT guided resection of osteoid osteoma was first reported for management of lesions in the appendicular skeleton [2,46] and subsequently applied to the spine [37]. Because of the potential risk of accidental penetration of the spinal canal [2,31,33] and the frequent failures of percutaneous CT guided resection of spinal lesions [2,46], as opposed to the successful management of osteoid osteomas of the extremities [2,5,11,29,34,40,46,49], its popularity has not gained momentum. Percutaneous radiofrequency ablation has been proposed as an alternative method to overcome limitations of percutaneous resection.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous core excision and radiofrequency thermo-coagulation for the ablation of osteoid osteoma of the spine

et al. 2008

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Percutaneous radiofrequency ablation is the treatment of choice for osteoid osteoma of the appendicular skeleton. However, difficulties in localizing the lesion in the spine and its proximity to neural elements have yet to make it the prevalent treatment for spine. This study assesses the safety and effectiveness of two percutaneous techniques for ablating osteoid osteoma of the spine. Seven patients were treated between 1998 and 2005. Four patients underwent percutaneous radiofrequency coagulation. The lesions were located at the articular processes of L3 and L4, the lamina of L3 and in the head of the 11th rib. Three patients with lesions in close proximity to neural structures (pedicle of T9, the posterolateral inferior aspect of L3 vertebral body and the inferior articular process of C5) were subjected to percutaneous core excision. Mean follow-up was 4.2 +/- 1.6 years. Three out of four patients who underwent radiofrequency ablation had an immediate and sustained response. One patient with a lesion in the head of the rib failed to respond. The three patients in the group of pecutaneous core excisional biopsy demonstrated immediate relief of pain. However, one patient experienced relapse of symptoms 6 months after transpedicular core excision. CT scan suggested partial targeting of the lesion that corroborated with histologic examination revealing only reactive tissue. Subsequent percutaneous core excision was successful. Therefore, the overall success rate was 85.7%. Mean VAS improved dramatically from 9 +/- 1 to 2 +/- 1 after surgery (P < 0.05). No neurological or other complications were encountered. This study indicates that radiofrequency ablation of spinal osteoid osteomas is safe and reasonably effective when an intact cortical shell separates the nidus from the neural elements. Percutaneous core excision can obviate the risk of thermal damage for lesions located in close proximity to the neural elements. Effectiveness of treatment can also be evaluated by CT scan and histological examination. Difficulties in targeting the nidus can lead to treatment failure. The minimal morbidity and the effectiveness of these minimally invasive procedures make them a valid alternative in the treatment of spinal osteoid osteoma.

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Section: Discussionmentioning

confidence: 99%

Percutaneous core excision and radiofrequency thermo-coagulation for the ablation of osteoid osteoma of the spine

et al. 2008

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“…However, the success rates of recurrence-free healing vary and are highly dependent on the interventionalist and the localization. While some authors (14) report no recurrences or complications, other authors report complications in 24% of the cases (30,31). On the other hand there are opinions (6) that the conventional operation techniques are better than the modern CT-guided ones because of the fact that a histological assessment of the often heavily damaged resectate is only possible in about half of the cases, so that the method should only be used in cases of a confirmed diagnosis of osteoid osteoma (31).…”

Section: ) Minimally Invasive Percutaneous Ct-guided Techniquementioning

confidence: 99%

Osteoid Osteoma – Synopsis of clinical, radiological, and therapeutical relevance of this rare entity

Mosler,

Mertineit,

Nöldge

2023

Swiss J Rad Nucl Med

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Characteristic of the osteoid osteoma is the so-called nidus enclosed in the tumor and produces a typical picture on X-ray. Since most physicians have little experience with the clinical picture of osteoid osteoma, this is an important reason for the often-long anamnesis time for osteoid osteoma (OO). The period of formation of OO includes the phase of strongest bone growth in childhood and adolescence. The most characteristic clinical symptom is nocturnal attacks of pain around the tumor, which occur independently of preceding physical activity and respond strikingly well to non-steroidal anti-inflammatory drugs (aspirin test). OO most frequently affects the long tubular bones of the lower extremities. Fifty percent of OO are found in the femur and tibia preferentially occurring in the corticalis of metaphysis and diaphysis. This is followed by the long tubular bones of the upper extremity and the short tubular bones. However, any other bone can also be affected. Differentially, osteoblastoma or osteosarcoma must be considered first and foremost. Most widely accepted therapy options are open surgery with en-bloc resection of the tumor, excochleation,minimally invasive percutaneous CT-guided radio or laser ablation. A conservative management by pharmaceutical pain therapy should be reserved for cases in which surgery must be refused either because of the precarious position of the nidus or because the patient's general condition does not permit it, or the patient does not consent to surgical interventions.

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“…Kleinere Knochen wie Talus oder Wirbelkörper sind seltener betroffen [3]. Die Ätiologie des Osteoidosteoms, als dessen Erstbeschreiber Jaffe gilt, ist noch ungeklärt [3,4,7]. Die Patienten sind in über 60% der Fälle zwischen 10 und 25 Jahre alt, dabei sind Männer doppelt so häufig betroffen wie Frauen [3].…”

Section: Schlüsselwörterunclassified

“…Konventionelle Röntgenaufnahmen und eine Skelettszintigraphie der betroffenen Region geben neben der klinischen Symptomatik oft weitere Hinweise auf ein Osteoidosteom, die Diagnose wird aber meist durch eine Computertomographie (High-Resolution (HR)-CT) mit geringer Schichtdicke von 2-5 mm) gesichert [3,4,11]. Radiologisch zeigt sich eine kleine runde Osteolysezone (Nidus), die von einem sklerotischen Randsaum und einer Hyperosteose umgeben ist [4].…”

Section: Schlüsselwörterunclassified

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Posttraumatisches Osteoidosteom

Leonhardt¹,

Bastian²,

Rosenthal

et al. 2001

Der Unfallchirurg

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Osteoid osteoma is a painful benign bone neoplasm that is rarely described after trauma but should be suspected. A case of osteoid osteoma 19 years after a tibial fracture is presented. The patient had pain in the tibia for 6 years before the osteoid osteoma was confirmed. He had been operated on twice for suspected osteomyelitis although the clinical symptoms suggested an osteoid osteoma. The radiographic appearance as well as a bone scan confirmed the diagnosis. Removal of the nidus resulted in immediate pain relief. A precise preoperative diagnosis of the lesion based on clinical findings, standard radiographs, high-resolution CT, and bone scan is mandatory. It is important to recognize this uncommon entity to avoid morbidity associated with a prolonged delay in diagnosis.

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Osteoid Osteoma

Cited by 34 publications

References 13 publications

Percutaneous core excision and radiofrequency thermo-coagulation for the ablation of osteoid osteoma of the spine

Percutaneous core excision and radiofrequency thermo-coagulation for the ablation of osteoid osteoma of the spine

Osteoid Osteoma – Synopsis of clinical, radiological, and therapeutical relevance of this rare entity

Posttraumatisches Osteoidosteom

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