Radiofrequency Ablation of Spinal Osteoid Osteoma

Abstract

In Brief Study Design. A prospective study on 24 patients with spinal osteoid osteoma treated with radiofrequency ablation (RFA). Objective. To determine if and when computed tomography (CT)-guided RFA is a safe and effective treatment for spinal osteoid osteomas. Summary of Background Data. Surgery has been considered the standard treatment for spinal osteoid osteomas. Surgery may cause spinal instability, infection, and nervous injury. We evaluated CT-guided RFA as an alternative treatment. Methods. A total of 28 RFA procedures in 24 patients with spinal osteoid osteoma were performed, using a 5-mm noncooled electrode. Clinical symptoms and spinal deformity were evaluated before and after the procedure. Unsuccessful treatment was defined as the presence of residual or recurrent symptoms. The mean follow-up was 72 months (range: 9–142 months). Results. Nineteen (79%) patients were successfully treated after 1 RFA, and all except one after repeat RFA. One patient with nerve root compression needed further surgery. No complications were observed. Spinal deformity persisted in 3 of 7 patients after successful RFA. Conclusion. CT-guided RFA is a safe and effective treatment for spinal osteoid osteoma. Surgery should be reserved for lesions causing nerve root compression. The clinical outcome of 24 patients with spinal osteoid osteoma treated with computed tomography-guided radiofrequency ablation is reported. Nineteen patients (79%) were successfully treated after 1 session and all except 1 patient were successfully treated after repeat radiofrequency ablation. No postprocedural complications were observed.