RADIOABLATION FOR OSTEOID OSTEOMA

Abstract

This study was designed to be the first to prospectively evaluate CT-guided radiofrequency ablation for osteoid osteoma in terms of pain control, medication consumption, quality of life and patient function.

Over two years, forty patients with symptoms and radiographic findings classic for osteoid osteoma were offered radioablation. Patients were asked to fill out facial, subjective and visual analog pain scales and to undergo the Musculoskeletal Tumour Society 1987 functional assessment.

Results show immediate and lasting resolution of symptoms, a sharp drop in drug use and a significant improvement in function thus supporting the role of radioablation as first line therapy.

The purpose of this study was to prospectively evaluate the usefulness of radioablation for osteoid osteoma in terms of pain control, analgesic drug consumption, quality of life and patient function.

Radioablation appears to be a safe and effective method of treatment for osteoid osteoma. It offers immediate and lasting resolution of symptoms. Results support its role as first line therapy.

This is the first study to prospectively measure the outcome of patients treated with CT-guided radiofrequency ablation for osteoid osteoma.

The mean follow-up time is 6.93 months (sd: 6.51). All but seven procedures were done under regional anaesthesia. No complications were reported. 50% of core biopsy specimens were diagnostic of osteoid osteoma. The visual analog pain scale showed a value of 2.13(sd: 2.5) pre-op and 0.33(sd: 1.07) at 1 year (p=0.00033). The MSTS score rose from 28.86(sd: 4.68) pre-operatively to 34.06(sd: 1.95) after one year (p=0.000000049). Medication consumption was markedly reduced. All eighteen patients with more than one- year follow-up are drug free.

Over two years, forty patients with symptoms and radiographic findings classic for osteoid osteoma who had already received various treatments were offered radioablation. Written consent was obtained and patients were asked to fill out facial, subjective and visual analog pain scales. The Musculoskeletal Tumour Society 1987 functional assessment was performed. This data was collected two weeks prior to treatment and then at two weeks, three months and one year after treatment. The procedure was performed under CT guidance and on a one-day hospital admission basis.