Radiofrequency ablation is as safe and effective as surgical excision for spinal osteoid osteoma: a systematic review and meta-analysis

Alessandro Sangiorgio; Lorenzo Massimo Oldrini; Christian Candrian; Costantino Errani; Giuseppe Filardo

doi:10.1007/s00586-022-07411-8

Radiofrequency ablation is as safe and effective as surgical excision for spinal osteoid osteoma: a systematic review and meta-analysis

Eur Spine J. 2023 Jan;32(1):210-220. doi: 10.1007/s00586-022-07411-8. Epub 2022 Oct 10.

Authors

Alessandro Sangiorgio¹, Lorenzo Massimo Oldrini², Christian Candrian^{2

3}, Costantino Errani⁴, Giuseppe Filardo^{2

3

5}

Affiliations

¹ Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland. Alessandro.Sangiorgio@eoc.ch.
² Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.
³ Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
⁴ Clinica Ortopedica e Traumatologica III, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
⁵ Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

PMID: 36214895
DOI: 10.1007/s00586-022-07411-8

Abstract

Background: Osteoid osteoma (OO) is a primary benign tumor that affects mainly young patients. Ten percent of all OO are located in the vertebral column. Treatment of spinal OO is challenging and there is no consensus in the literature on the best operative approach.

Purpose: The aim of this systematic review and meta-analysis was to determine safety and efficacy of radiofrequency ablation (RFA) versus surgical excision for the treatment of spinal OO.

Methods: A literature search was performed on PubMed, Web of Science, and Embase from inception up to 22 March 2022. Studies addressing surgical excision or RFA for the treatment of spinal OO were included. The main outcomes evaluated were pain before and after intervention, the treatments success rate, defined as complete pain relief with no recurrence until the last follow-up, and the number and type of complications.

Results: Thirty-one studies (749 patients) were included. For patients who underwent surgical excision, 19 studies reported a mean treatment success rate of 85.6%, while in the RFA treatment group, 18 studies reported a mean success rate of 88.6%. At last follow-up, the pooled mean difference in pain scores from baseline on a 0-10 scale was 5.8 points in the surgical excision group and 6.7 points in the RFA group. Recurrences were observed in 5.6% of the patients who underwent surgical excision and in 6.7% of the patients treated with RFA. The complication rate was 7.8% in the surgical excision group and 4.4% in the RFA group.

Conclusions: This meta-analysis found high global success rates for both surgical and RFA treatments. Both treatments were efficient in pain relief and presented a low rate of recurrences. The complication rate was low for both treatments. Compared to surgical excision, RFA is a less invasive procedure which proved to be a safe and as effective option for the treatment of spinal OO.

Keywords: Osteoid osteoma; RFA; Spine; Surgical excision.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Bone Neoplasms* / surgery
Catheter Ablation* / adverse effects
Catheter Ablation* / methods
Humans
Osteoma, Osteoid* / diagnostic imaging
Osteoma, Osteoid* / surgery
Pain / etiology
Radiofrequency Ablation*
Spinal Neoplasms* / surgery
Spine / surgery
Treatment Outcome