Purpose
To report our experience with percutaneous cool-tip radiofrequency treatment of osteoid osteomas with special emphasys in certain locations and to evaluate clinical outcome.
Material and methods
Sixty-one patients with clinically and radiologically suspected osteoid osteoma were seen over a 60-month period (males: 38 females: 23; 5 to 43 years; mean age: 19.7). All patients were treated by CT-guided percutaneous radiofrequency ablation. The procedure was performed under regional or general anaesthesia. After localisation of the nidus, a 14G bone biopsy needle is introduced into the nidus. The radiofrequency needle with a 10-mm active tip (Cool-tip) is inserted through the biopsy needle and is connected to the RF generator for 4 minutes providing the core temperature reaching a minimum range of 45ºC and could be extended up to 6-8 minutes if less than this temperature were reached. Eight cases were located in the spine and ten osteoid osteomas were intraarticular. The electrode were heated at 90ºC for 4 minutes in these special cases in order to prevent damage to adjacent structures.
Results
Primary success was obtained in 58 patients with a 100% secondary success rate, who are currently pain-free. No major complications occurred. Patients could resume unrestricted normal activity within 24-48 hours.
Conclusion
Percutaneous radiofrequency ablation of osteoid osteomas is an efficient and safe method that can be considered the procedure of choice for most cases including spinal and intraarticular cases.