Long-term clinical outcomes of dual-cycle radiofrequency ablation technique for treatment of osteoid osteoma

Skeletal Radiol. 2016 May;45(5):599-606. doi: 10.1007/s00256-015-2321-3. Epub 2016 Jan 21.

Abstract

Purpose: Radiofrequency ablation technique for treatment of OO including ablation time and temperature vary greatly between and within reported studies. This study evaluates the immediate and long-term efficacy and complication rate of a two sequential RFA technique for OO.

Materials and methods: We retrospectively reviewed medical records and attempted interview follow-up for 25 patients treated with RFA for OO. Each treatment included 2 consecutive RFAs at 90 °C for 6 min with inter-ablation cooling to 40 °C and occasional inter-ablation probe adjustment. Additionally, we statistically compared the proportion of successful ablations using the DCRFA technique with published studies that utilized alternative OO ablation procedures.

Results: Long-term follow-up was obtained for 24 patients (96 %). Mean patient age at DCRFA was 17.2 years (range, 2.2-50.0 years). Mean time to follow-up was 60 ± 42 months (range 12-152 months). No acute DCRFA-related complications nor long-term recurrences were reported. All 24 interviewed patients reported partial relief of pre-procedural pain within 1 day of DCRFA and total relief within 1 week of DCRFA. One patient ultimately developed a major late complication (complex regional pain syndrome of the left ankle) after DCRFA of a cuboid lesion. Additionally, the DCRFA success rate was significantly higher when compared to two other published OO RFA treatment results.

Conclusion: DCRFA employing two sequential 6-min cycles is an effective treatment of OO. The 100 % primary success rate, 0 % long-term recurrence rate, and low complication rate compare favorably and may be superior to results of prior reports.

Keywords: Catheter ablation; Image-guided surgery; Musculoskeletal pain; Neoplasms; Osteoid; Osteoma; Radiofrequency.

MeSH terms

  • Adolescent
  • Adult
  • Arthralgia / diagnosis
  • Arthralgia / etiology*
  • Bone Neoplasms / complications
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / surgery*
  • Catheter Ablation / adverse effects*
  • Catheter Ablation / methods*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Osteoma, Osteoid / complications
  • Osteoma, Osteoid / diagnostic imaging
  • Osteoma, Osteoid / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult