Percutaneous Radiofrequency Ablation for Osteoid Osteoma
Osteoid osteoma is a benign [non-cancerous] tumor that consists of osteoblastic mass called a nidus. Nidus is very rich in blood supply. Nidus is surrounded by a zone of sclerotic but otherwise normal bone. The zone of sclerosis represents a secondary reversible change that gradually disappears after the removal of the nidus. This sclerosis is kind of reaction to the tumor because it reverses on removal of nidus. The nidus tissue has a limited local growth potential and usually is less than 2 cm in diameter.
Procedure:
An electrode is placed in the lesion which is coupled to a radiofrequency generator. This would lead to that produces local tissue destruction by converting radiofrequency into heat. This method can treat smaller lesion in single application. Larger lesions may require a second application.
The patients can be sent home same day and is method of choice in suitable patients. The procedure is most suited for treatment if the location of the osteoid osteoma should permit a safe access and a safe heating procedure without risking damaging nerves, major blood vessels and the skin.
Complete or nearly complete relief of pain often occurs within 3 days. Younger patients and lesion of 10 mm are associated with increased risk of treatment failure.
Primary cure rates are 83-94%. Cure with a second ablation procedure is approximately 100.
Patients may return to work, school and other normal activities usually within the first week after the procedure. Athletic activities are prohibited for 3 months.
It should be considered that recurrence rates of 10-20% have been described and a second procedure may sometimes be required especially in large lesions.
Percutaneous radiofrequency coagulation is currently the preferred treatment for osteoid osteoma because it does not require hospitalization, is not associated with complications, and is associated with rapid convalescence.