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Rofo 2013; 185(10): 959-966
DOI: 10.1055/s-0033-1350347
Interventionelle Radiologie
© Georg Thieme Verlag KG Stuttgart · New York

Radiofrequency Ablation of Osteoid Osteomas: Analgesia and Patient Satisfaction in Long-term Follow-up

Radiofrequenzablation von Osteoidosteomen: Schmerzfreiheit und Patientenzufriedenheit im Langzeitverlauf
B. Gebauer
1   Department of Radiology, Charité – Universitätsmedizin Berlin
,
F. Collettini
1   Department of Radiology, Charité – Universitätsmedizin Berlin
,
C. Bruger
1   Department of Radiology, Charité – Universitätsmedizin Berlin
,
K.-D. Schaser
2   Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin
,
I. Melcher
2   Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin
,
P.-U. Tunn
3   Department of Orthopaedic Oncology, HELIOS-Klinikum Berlin-Buch
,
F. Streitparth
1   Department of Radiology, Charité – Universitätsmedizin Berlin
› Author Affiliations
Further Information

Publication History

08 January 2013

01 July 2013

Publication Date:
23 August 2013 (online)

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Abstract

Purpose: To review the long term clinical outcomes in the treatment of osteoid osteoma (OO) using radiofrequency ablation (RFA).

Materials and Methods: Our retrospective study included 59 patients who were treated in the period from April 2001 to December 2012 due to a symptomatic OO using RFA. Here, the occurrence of complications and postoperative recurrence, as well as postoperative patient satisfaction were examined. Patients satisfaction was assessed by means of a telephone interview with the visual analogue scale (VAS).

Results: Mean follow-up was 50 months (2 – 116 months). The average size of the nidus was 6 mm (range 2 – 14 mm). After initial radiofrequency ablation 11.8 % (7/59) of patient showed a recurrence of symptoms. Symptoms could successfully be treated by a second ablation in 5 patients. Assisted success rate was therefore 96.6 % (57/59). The complication rate was 5.1 % (2 major and one minor complication). Furthermore we report a very high patient satisfaction and acceptance of therapy.

Conclusion: RFA is a very successful therapy of symptomatic OOs with a high patient satisfaction.

Key Points:

  • Osteoid osteomas (OO) are rare benign bone tumors of the childhood and adolescence.

  • Treatment of OOs with minimal-invasive radiofrequency ablation (RFA) shows a high patient satisfaction.

  • RFA is by now the standard therapy of symptomatic OOs.

Citation Format:

  • Gebauer B, Collettini F, Bruger C et al. Radiofrequency Ablation of Osteoid Osteomas: Analgesia and Patient Satisfaction in Long-term Follow-up. Fortschr Röntgenstr 2013; 185: 959-966

Zusammenfassung

Ziel: Ermittlung des klinischen Erfolgs und der Patientenzufriedenheit nach Radiofrequenzablation (RFA) von symptomatischen Osteoidosteomen (OO) im Langzeitverlauf.

Material und Methoden: Unsere retrospektive Studie umfasste 59 Patienten, die im Zeitraum von April 2001 bis Dezember 2012 aufgrund eines symptomatischen OO mittels RFA behandelt wurden. Dabei wurden Rezidive und Komplikationen sowie die postinterventionelle Patientenzufriedenheit ermittelt. Die Patientenzufriedenheit und der Restschmerz (visuelle Analogskala [VAS]) wurden mittels eines standardisierten Telefoninterviews ermittelt.

Ergebnisse: Der Nachbeobachtungszeitraum erstreckte sich im Durchschnitt über 50 Monate (2 – 116 Monate). Die durchschnittliche Größe des Nidus lag bei 6 mm (2 – 14 mm). Die initiale Radiofrequenzablation zeigte in 11,8 % (7/59) ein Rezidiv der Schmerzsymptomatik, das bei 5 Patienten mittels einer zweiten Ablation erfolgreich behandelt werden konnte. Die assistierte Erfolgsrate war somit 96,6 % (57/59). Die Komplikationsrate lag bei 5,1 % (2 Major- und eine Minor-Komplikation). Darüber hinaus konnten wir eine sehr hohe Patientenzufriedenheit und Therapieakzeptanz feststellen.

Schlussfolgerung: Die RFA ist ein sehr erfolgreiches Therapieverfahren von symptomatischen Osteoidosteomen mit hoher Patientenzufriedenheit.

Key words

ablation procedures - radiofrequency ablation - osteoid osteoma - complication - patient satisfaction

Deutscher Artikel/German Article

 

  • Literatur

  • 1 Jaffe HL. Osteoid osteoma: a benign osteoblastic tumor composed of osteoid and atypical bone. Arch Surg 1935; 31: 709-728
    CrossrefPubMedGoogle Scholar
  • 2 Mungo DV, Zhang X, O’Keefe RJ et al. COX-1 and COX-2 expression in osteoid osteomas. J Orthop Res 2002; 20: 159-162
    CrossrefPubMedGoogle Scholar
  • 3 Bloem JL, Kroon HM. Osseous lesions. Radiologic clinics of North America 1993; 31: 261-278
    PubMedGoogle Scholar
  • 4 Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid-osteoma. J Bone Joint Surg Am 1992; 74: 179-185
    PubMedGoogle Scholar
  • 5 Moberg E. The natural course of osteoid osteoma. J Bone Joint Surg Am 1951; 33: 166-170
    PubMedGoogle Scholar
  • 6 Ilyas I, Younge DA. Medical management of osteoid osteoma. Can J Surg 2002; 45: 435-437
    PubMedGoogle Scholar
  • 7 Rosenthal DI, Alexander A, Rosenberg AE et al. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 1992; 183: 29-33
    CrossrefPubMedGoogle Scholar
  • 8 Cantwell CP, Obyrne J, Eustace S. Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation. Eur Radiol 2004; 14: 607-617
    CrossrefPubMedGoogle Scholar
  • 9 Liu PT, Kujak JL, Roberts CC et al. The vascular groove sign: a new CT finding associated with osteoid osteomas. Am J Roentgenol American journal of roentgenology 2011; 196: 168-173
    PubMedGoogle Scholar
  • 10 Yaniv G, Shabshin N, Sharon M et al. Osteoid osteoma--the CT vessel sign. Skeletal Radiol 2011; 40: 1311-1314
    CrossrefPubMedGoogle Scholar
  • 11 Omary RA, Bettmann MA, Cardella JF et al. Quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol 2003; 14: S293-S295
    CrossrefPubMedGoogle Scholar
  • 12 Sacks D, McClenny TE, Cardella JF et al. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 2003; 14: S199-S202
    CrossrefPubMedGoogle Scholar
  • 13 Freiberger RH, Loitman BS, Helpern M et al. Osteoid osteoma; a report on 80 cases. The American journal of roentgenology, radium therapy, and nuclear medicine 1959; 82: 194-205
    PubMedGoogle Scholar
  • 14 Campanacci M, Ruggieri P, Gasbarrini A et al. Osteoid osteoma. Direct visual identification and intralesional excision of the nidus with minimal removal of bone. J Bone Joint Surg Br 1999; 81: 814-820
    CrossrefPubMedGoogle Scholar
  • 15 Sluga M, Windhager R, Pfeiffer M et al. Peripheral osteoid osteoma. Is there still a place for traditional surgery?. J Bone Joint Surg Br 2002; 84: 249-251
    CrossrefPubMedGoogle Scholar
  • 16 Ward WG, Eckardt JJ, Shayestehfar S et al. Osteoid osteoma diagnosis and management with low morbidity. Clin Orthop Relat Res 1993; 229-235
    PubMedGoogle Scholar
  • 17 Yildiz Y, Bayrakci K, Altay M et al. Osteoid osteoma: the results of surgical treatment. Int Orthop 2001; 25: 119-122
    CrossrefPubMedGoogle Scholar
  • 18 Kohler R, Rubini J, Postec F et al. Treatment of osteoid osteoma by CT-controlled percutaneous drill resection. Apropos of 27 cases. Rev Chir Orthop Reparatrice Appar Mot 1995; 81: 317-325
    PubMedGoogle Scholar
  • 19 Parlier-Cuau C, Champsaur P, Nizard R et al. Percutaneous removal of osteoid osteoma. Radiologic clinics of North America 1998; 36: 559-566
    CrossrefPubMedGoogle Scholar
  • 20 Roderer G, Nelitz M, Puhl W et al. Minimalinvasive Therapie bei Osteoidosteom. Z Orthop Ihre Grenzgeb 2004; 142: 456-461
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Greenspan A. Sklettradiologie: Orthopädie, Traumatologie, Rheumatologie, Onkologie. 3 ed. München: Urban & Fischer Verlag/Elsevier GmbH; 2007
    Google Scholar
  • 22 Lee DH, Malawer MM. Staging and treatment of primary and persistent (recurrent) osteoid osteoma. Evaluation of intraoperative nuclear scanning, tetracycline fluorescence, and tomography. Clin Orthop Relat Res 1992; 229-238
    PubMedGoogle Scholar
  • 23 Mahnken AH, Bruners P, Delbruck H et al. Radiofrequency ablation of osteoid osteoma: initial experience with a new monopolar ablation device. Cardiovasc Intervent Radiol 2011; 34: 579-584
    CrossrefPubMedGoogle Scholar
  • 24 Norman A. Persistence or recurrence of pain: a sign of surgical failure is osteoid-osteoma. Clin Orthop Relat Res 1978; 263-266
    PubMedGoogle Scholar
  • 25 Kjar RA, Powell GJ, Schilcht SM et al. Percutaneous radiofrequency ablation for osteoid osteoma: experience with a new treatment. Med J Aust 2006; 184: 563-565
    PubMedGoogle Scholar
  • 26 Rosenthal DI, Hornicek FJ, Wolfe MW et al. Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg Am 1998; 80: 815-821
    CrossrefPubMedGoogle Scholar
  • 27 Rosenthal DI, Springfield DS, Gebhardt MC et al. Osteoid osteoma: percutaneous radio-frequency ablation. Radiology 1995; 197: 451-454
    CrossrefPubMedGoogle Scholar
  • 28 Barei DP, Moreau G, Scarborough MT et al. Percutaneous radiofrequency ablation of osteoid osteoma. Clin Orthop 2000; 115-124
    PubMedGoogle Scholar
  • 29 Donkol RH, Al-Nammi A, Moghazi K. Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children. Pediatric radiology 2008; 38: 180-185
    CrossrefPubMedGoogle Scholar
  • 30 Lindner NJ, Ozaki T, Roedl R et al. Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg Br 2001; 83: 391-396
    CrossrefPubMedGoogle Scholar
  • 31 Osti OL, Sebben R. High-frequency radio-wave ablation of osteoid osteoma in the lumbar spine. Eur Spine J 1998; 7: 422-425
    CrossrefPubMedGoogle Scholar
  • 32 Rimondi E, Bianchi G, Malaguti MC et al. Radiofrequency thermoablation of primary non-spinal osteoid osteoma: optimization of the procedure. European radiology 2005; 15: 1393-1399
    CrossrefPubMedGoogle Scholar
  • 33 Rosenthal DI, Hornicek FJ, Torriani M et al. Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 2003; 229: 171-175
    CrossrefPubMedGoogle Scholar
  • 34 Vanderschueren GM, Taminiau AH, Obermann WR et al. Osteoid osteoma: clinical results with thermocoagulation. Radiology 2002; 224: 82-86
    CrossrefPubMedGoogle Scholar
  • 35 Woertler K, Vestring T, Boettner F et al. Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients. J Vasc Interv Radiol 2001; 12: 717-722
    CrossrefPubMedGoogle Scholar
  • 36 Hoffmann RT, Jakobs TF, Kubisch CH et al. Radiofrequency ablation in the treatment of osteoid osteoma-5-year experience. Eur J Radiol 2010; 73: 374-379
    CrossrefPubMedGoogle Scholar
  • 37 Rybak LD, Gangi A, Buy X et al. Thermal ablation of spinal osteoid osteomas close to neural elements: technical considerations. Am J Roentgenol American journal of roentgenology 2010; 195: W293-W298
    PubMedGoogle Scholar
  • 38 Vanderschueren GM, Obermann WR, Dijkstra SP et al. Radiofrequency ablation of spinal osteoid osteoma: clinical outcome. Spine 2009; 34: 901-904
    CrossrefPubMedGoogle Scholar
  • 39 Rimondi E, Mavrogenis AF, Rossi G et al. Radiofrequency ablation for non-spinal osteoid osteomas in 557 patients. Eur Radiol 2012; 22: 181-188
    CrossrefPubMedGoogle Scholar
  • 40 Omlor G, Merle C, Lehner B et al. CT-guided percutaneous radiofrequency ablation in osteoid osteoma: re-assessments of results with optimized technique and possible pain patterns in mid-term follow-up. Fortschr Röntgenstr 2012; 184: 333-339
    Article in Thieme ConnectPubMedGoogle Scholar
  • 41 Rehnitz C, Sprengel SD, Lehner B et al. CT-guided radiofrequency ablation of osteoid osteoma and osteoblastoma: clinical success and long-term follow up in 77 patients. Eur J Radiol 2012; 81: 3426-3434
    CrossrefPubMedGoogle Scholar
  • 42 Cichon CW, Bottner F, Rodl R et al. Die minimalinvasive Therapie beim Osteoidosteom mittels CT-gesteuerter Thermokoagulation im Langzeitverlauf. Zeitschrift fur Orthopadie und ihre Grenzgebiete 2006; 144: 332-337
    PubMedGoogle Scholar
  • 43 Peyser A, Applbaum Y, Simanovsky N et al. CT-guided radiofrequency ablation of pediatric osteoid osteoma utilizing a water-cooled tip. Ann Surg Oncol 2009; 16: 2856-2861
    CrossrefPubMedGoogle Scholar
  • 44 Jankharia B, Burute N. Percutaneous radiofrequency ablation for osteoid osteoma: How we do it. The Indian journal of radiology & imaging 2009; 19: 36-42
    Article in Thieme ConnectPubMedGoogle Scholar
  • 45 Cioni R, Armillotta N, Bargellini I et al. CT-guided radiofrequency ablation of osteoid osteoma: long-term results. Eur Radiol 2004; 14: 1203-1208
    PubMedGoogle Scholar
  • 46 Neumann D, Berka H, Dorn U et al. Follow-up of thirty-three computed-tomography-guided percutaneous radiofrequency thermoablations of osteoid osteoma. Int Orthop 2011; 36: 811-815
    PubMedGoogle Scholar
  • 47 Sung KS, Seo JG, Shim JS et al. Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma-2 to 5 years follow-up. Int Orthop 2009; 33: 215-218
    CrossrefPubMedGoogle Scholar
  • 48 Ockendon M, Gregory JJ, Cribb GL et al. Osteoid osteoma: can impedance levels in radiofrequency thermocoagulation predict recurrence?. Radiology research and practice 2011; 2011: 753502
    PubMedGoogle Scholar
  • 49 Mylona S, Patsoura S, Galani P et al. Osteoid osteomas in common and in technically challenging locations treated with computed tomography-guided percutaneous radiofrequency ablation. Skeletal radiology 2010; 39: 443-449
    CrossrefPubMedGoogle Scholar
  • 50 Ghanem I. The management of osteoid osteoma: updates and controversies. Curr Opin Pediatr 2006; 18: 36-41
    CrossrefPubMedGoogle Scholar
  • 51 Schmidt D, Clasen S, Schaefer JF et al. CT-gesteuerte Radiofrequenz(RF)-Ablation von Osteoidosteomen: klinische Langzeitergebnisse. Fortschr Röntgenstr 2011; 183: 381-387
    Article in Thieme ConnectPubMedGoogle Scholar
  • 52 Mastrantuono D, Martorano D, Verna V et al. Osteoid osteoma: our experience using radio-frequency (RF) treatment. Radiol Med 2005; 109: 220-228
    PubMedGoogle Scholar
  • 53 Kyriakopoulos KK, Mavrogenis AF, Pappas J et al. Percutaneous computed tomography-guided radiofrequency ablation of osteoid osteomas. Eur J Orthop Surg Traumatol 2007; 17: 8
    PubMedGoogle Scholar