Osteoid osteoma treated with radiofrequency ablation in non-operating room anesthesia. A different way of approaching ablative therapy on osteoid osteoma

Eur Rev Med Pharmacol Sci. 2018 Sep;22(17):5438-5446. doi: 10.26355/eurrev_201809_15803.

Abstract

Objective: The purpose of this study is to verify the effectiveness and complications occurrence of radiofrequency ablation (RFA) in the treatment of osteoid osteoma (OO) in non-operating room anesthesia (N.O.R.A.).

Patients and methods: From 2014 to 2017, 61 patients affected by OO (40 men and 21 women) with an age of 20.7 years on average (range, 4-51 years; 12 patients aged 20 years or younger) underwent computed tomography-guided percutaneous radiofrequency ablation (RFA) in N.O.R.A. (Non-Operating Room Anesthesia). Lesion sites treated were: femur (27), tibia (22), pelvis (2), talar bone (3), distal radius (1), and humerus (6). Mean follow-up time was 36 months. In each case, anesthesiologic support followed a new protocol (N.O.R.A. protocol), approved by our Institute. Primary success rate, complications, symptom-free intervals, and follow-up results were evaluated.

Results: Pain relief (evaluated with Visual Analogue Scale - VAS) was significant in 97% of patients; it disappeared within 24 hours of the procedure in 44 patients, within 3 days in 10 patients, and within 7 days in 7 patients. After 6 months of observation time, 60 of 61 patients were successfully treated and had no more complaints. In 2 patients, two major complications were found: infection of the site treated, healed with antibiotics, and a nerve lesion, healed with steroid therapy. No other complications were observed.

Conclusions: RFA is a highly effective, efficient, minimally invasive and safe method for the treatment of OO following N.O.R.A.

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, Local / methods*
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / surgery*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Osteoma, Osteoid / diagnostic imaging*
  • Osteoma, Osteoid / surgery*
  • Pain Management / methods
  • Radiofrequency Ablation / methods*
  • Treatment Outcome
  • Young Adult