Radiofrequency ablation is as safe and effective as surgical excision for spinal osteoid osteoma: a systematic review and meta-analysis

Sangiorgio, Alessandro; Oldrini, Lorenzo Massimo; Candrian, Christian; Errani, Costantino; Filardo, Giuseppe

doi:10.1007/s00586-022-07411-8

Cited by 10 publications

(4 citation statements)

References 47 publications

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“…The complication rate was also lower in the RFA group compared to the surgical group. Sangiorgio et al could also show that RFA has a lower complication rate of 4.4% in comparison to surgical excision with 7.8% [26]. Though, the recurrence rate was slightly higher in the RFA group, with 6.7% [26].…”

Section: Discussionmentioning

confidence: 91%

“…Furthermore, in a meta-analysis by Efthymiadis et al regarding osteoid osteoma of the hip, the authors propose RFA as a first-line treatment in comparison to percutaneous resection drilling and arthroscopy, due to its success rate of above 98% and its relatively low complication rate, although two iatrogenic femur fractures were reported [28]. Therefore, surgical excision may result in similar recurrence rates as RFA, though on the other hand, RFA has lower complication rates and is performed in a shorter period of time [21,25,26].…”

Section: Discussionmentioning

confidence: 99%

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Short- and Long-Term Outcomes after Radiofrequency Ablation of Osteoid Osteomas

Vogl,

Bialek,

Eichler

et al. 2024

JPM

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The aim of this study was to evaluate treatment of osteoid osteomas using bipolar radiofrequency ablation (RFA) and patients’ quality of life before and after therapy. We retrospectively evaluated patients who underwent bipolar RFA of osteoid osteomas between 2001 and 2016. We assessed patients’ symptoms before and after treatment (four weeks after treatment and long-term) using a questionnaire including severity and quality of pain on a 10-point scale (1 = no pain, 10 = severe pain), motion restrictions, pain-related sleep disorders, and necessary pain medication. In addition, we evaluated technical success, complications, hospitalization length, and patients’ satisfaction with treatment. This study included 62 patients (43 [69.4%] males, 26.2 ± 13.2 years). Average nidus size was 5.7 ± 2.6 mm. The rate of technical success was 100%. All RFAs were performed without any complications. One patient showed a recurrence, resulting in a recurrence rate of 1.6%, which was successfully treated by another session of RFA. Average hospitalization length was 1.5 ± 0.5 days. A total of 36 patients (58.1%) participated in the questionnaire, reporting an average pain severity of 8.2 ± 1.6 before RFA compared to 3.4 ± 3.0 four weeks after and an average of 2.1 ± 2.3, 6.6 years after therapy, (both p < 0.001). After therapy, 31 (86.1%) patients had no pain. The majority of patients (n = 34, 94.4%) had reduced or absent motion restriction after therapy (p < 0.001). Patient satisfaction rate was 91.7%. In conclusion, bipolar RFA is a safe and effective treatment modality for osteoid osteomas and improves quality of life by reducing pain severity and motion restrictions.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Short- and Long-Term Outcomes after Radiofrequency Ablation of Osteoid Osteomas

Vogl,

Bialek,

Eichler

et al. 2024

JPM

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“…The main disadvantages of this therapy are the lack of histological study, which is essential to confirm the diagnosis [12] , and difficulty performing in specific anatomical locations, such as the spine, due to the high risk of iatrogenic injury to neurovascular structures [11] . Although Sangiorgio, Alessandro, et al concluded in their meta-analysis that it is safe for spinal lesions and as effective as surgical excision [13] . However, skin burns and heat-induced injuries to neurovascular structures are significant complications; therefore, we must ensure good technical performance [12] .…”

Section: Discussionmentioning

confidence: 98%

Successful en-bloc excision for recurrent femoral osteoid osteoma: The use in modern era

Mhana¹,

Diri²,

Halloum³

et al. 2023

International Journal of Surgery Case Reports

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“…[ 8 9 10 14 16 18 ] This procedure can be performed multiple times with no risk of radiobiological exposure, providing immediate and significant pain relief. [ 14 17 19 ] Shawky AbdelGawaad et al . [ 20 ] examined in detail the association between radiofrequency ablation (RFA) and kyphoplasty in the treatment of painful spinal metastases.…”

Section: Discussionmentioning

confidence: 99%

Enhancing palliative care in vulnerable patients: Robot-assisted radiofrequency ablation for multiple spinal metastases – Technical insights and preliminary outcomes

Ricciardo,

Garufi,

Scalia

et al. 2024

Journal of Craniovertebral Junction and Spine

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Background: Radiofrequency thermal ablation (RFA) coupled with vertebroplasty or kyphoplasty offers a minimally invasive, safe, and efficacious approach to palliate polymetastatic spine disease, particularly in medically fragile individuals. However, the application of robotic assistance to RFA for spinal metastases remains unexplored. This study elucidates the technical viability of robot-assisted RFA combined with vertebroplasty in patients afflicted by multiple spinal metastases and presents preliminary outcomes. An illustrative case was also presented. Materials and Methods: Ten patients aged over 65 years with multiple vertebral metastases were enrolled in this study. Preoperatively, patients exhibited a median Visual Analog Scale (VAS) pain score of 6 and a Median Oswestry Disability Index (ODI) score of 58%. From February 2021 to April 2022, all patients underwent RFA, followed by vertebroplasty for spinal metastases. Surgical procedures were executed using the ExcelsiusGPS® robotic platform. Results: Patients experienced substantial pain relief, with a median VAS score of 2.5 at 24 h postoperatively (Δ −−3.5; P < 0.001) and a median VAS score of 2 at 1 month postoperatively (Δ −4; P < 0.001). All patients were discharged on the first postoperative day and continued their oncological treatments. In addition, the median ODI score at 1 month postoperatively was 34% (Δ −−24%; P = 0.006), indicating an enhanced quality of life and a satisfactory impact on daily activities. No procedural or postoperative complications were documented. Conclusions: This case series represents the inaugural successful application of robot-assisted RFA in conjunction with concurrent vertebroplasty/kyphoplasty. Our preliminary experience demonstrates that patients with oligo- and polymetastatic conditions can derive benefits from this minimally invasive intervention, characterized by rapid postoperative recovery and effective short- to medium-term pain management, without encountering complications.

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Radiofrequency ablation is as safe and effective as surgical excision for spinal osteoid osteoma: a systematic review and meta-analysis

Cited by 10 publications

References 47 publications

Short- and Long-Term Outcomes after Radiofrequency Ablation of Osteoid Osteomas

Short- and Long-Term Outcomes after Radiofrequency Ablation of Osteoid Osteomas

Successful en-bloc excision for recurrent femoral osteoid osteoma: The use in modern era

Enhancing palliative care in vulnerable patients: Robot-assisted radiofrequency ablation for multiple spinal metastases – Technical insights and preliminary outcomes

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