Advances in Management of Osteoid Osteoma by Radiofrequency Ablation

Abstract

Osteoid Osteoma is a benign painful skeletal neoplasm which is usually smaller than 1.5 cm. Surgery has been considered its standard treatment, currently, Percutaneous CT-guided Radiofrequency Ablation is proved to be the treatment of choice in such cases. Contrary to surgery, no major complications (infection or neurovascular injury) have been reported after radiofrequency ablation for spinal and non-spinal Osteoid Osteoma. Moreover, radiofrequency ablation can be easily repeated after initial treatment failure. As well as the almost absence of morbidity, as all patients could leave the hospital the same day of the procedure without any restrictions in activity. Pre-procedure diagnosis of Osteoid Osteoma by typical clinical history and presence of a distinct radiolucent nidus on thin slice CT scan is mandatory for treatment with RFA. CT guidance is almost inevitable during the procedure. General anesthesia is preferred than regional anesthesia or sedation for better immobilization during procedure whenever possible. Post procedural pain relief is the most credible sign of success as well as post procedure CT could provide signs of success, of which the most reliable is nidus ossification.