Mini-open excision of osteoid osteoma using burrs with the guidance of O-arm navigation / 中华骨科杂志

Objective:To investigate the surgical method and clinical effect of O-arm navigation mini-open burring for osteoid osteoma.Methods:Eighteen patients with osteoid osteoma were treated with O-arm guided grinding drill from June 2021 to May 2022, including 15 males and 3 females, the age was (18.4 ±10.9) years (range 2 to 44 years), and the course of disease ranged from 1 week to 3 years (mean 14.2 months). The lesions sites included 6 cases of proximal femur, 3 cases of distal femur, 4 cases of proximal tibia, 1 case of distal tibia, 2 cases of proximal fibula and 1 case of distal and proximal humerus. During the operation, the O-arm navigation was used to determine the location of the focus, the muscle and soft tissue was peeled off to the bone surface through a 1-4 cm small incision, the channel retractor was placed, and the burr was registered as a navigation recognition device to gradually remove the bone on the surface of the tumor nest, and the tumor nest was scraped with a curette for pathological examination; according to the navigation image, the focus was enlarged removed with burr and the grinding range was confirmed by the O-arm X-ray machine before the end of the operation. The patients were followed up for 6 to 15 months (mean 9.5 months). CT scans were performed before and after surgery for imaging comparison in order to figure out whether it had residual lesions or recurrence. The visual analogue score (VAS) of pain was used as a parameter for evaluating the clinical efficacy.Results:The operation time of 18 cases was 40-175 min, with an average of 89.3 min. The time required to establish navigation image was 18.0 ±4.1 min (range 13 ~ 22 min). The length of the incision was 2.7±1.1 cm (range 1-4 cm). All patients achieved complete curettage of the lesions, and osteoid osteoma was confirmed by pathology after operation. All the patients could move to the ground 24 hours after operation, and the pain was significantly relieved from 3 to 7 d after operation, and the pain almost disappeared 3 months after operation. The VAS score of 18 cases was 5.33±1.24 before surgery, 2.79±1.32 on the 3rd day, 1.86±1.21 on the 7th day, 0.86±0.93 on the 1st month, 0.33±0.48 on the 3rd month, and 0.09±0.29 on the 6th month after operation, and the difference was statistically significant ( F=58.50, P<0.001). There were no serious complications during and after operation, and the success rate of treatment (no recurrence of symptoms, no residual recurrence of imaging lesions, no serious complications after operation) was 100%. Conclusion:Treatment of osteoid osteoma with mini-open excision using burrs under the navigation of O-arm is a simple, safe, minimally invasive and efficient technique. Intraoperative precise positioning and the use of burr with navigation to remove a larger area than the tumor nest are the keys to successful treatment.

Uncooled microwave ablation of osteoid osteoma: New approaches to an old problem.

OBJECTIVE: This study aims to evaluate the technical and clinical success of uncooled microwave ablation (MWA) in the treatment of osteoid osteoma with two-dimensional fluoroscopy guidance in the operating room. METHODS: The clinical and imaging data of 9 patients were retrospectively evaluated. Mean patient age was 14.55 years. The mean size and volume of the lesions were 17.2 × 10.8 × 8.0 mm and the mean nidus size was 6.86±2.05 mm on computed tomography. MWA was performed with uncooled probe in operating room and in sterile conditions. Numerical pain score was recorded before the procedure, the day after, and at 1, 3 months after the procedure. RESULTS: Clinical and technical success was achieved in 100% of patients. The mean volume of MWA-induced necrosis was 20.8 × 12.8 × 10.7 mm, peripheral scar thickness was 3.5±0.75 mm, and none of the patients had nidus enhancement on first month follow-up magnetic resonance imaging. Fluoroscopic guidance was conducted under digital c-arm. Patients received four to 12 spot films (mean: 6.6 kVp, 2.66 mAs) over the lower extremity. Mean radiation exposure to the skin due to imaging was 0.02 mGy per patient per procedure. The dose area product-the total amount of radiation deliverable to the patient was 0.75±0.32 Gy.cm2. CONCLUSION: This study demonstrated the effectiveness and the safety of the uncooled MWA in osteoid osteoma. The technique may effectively be used in operating room under c-arm fluoroscopy. Such hybrid approach may ensure sterility, anesthetic safety, and lower radiation dose to patients.

Osteoid Osteoma in an Adult Wheelchair Basketball Player Mimicking Musculoskeletal Shoulder Pain: Red Flag or a Red Herring?

Osteoid osteoma (OO) is a relatively common, benign bone-forming tumour, which mainly occurs on the long tubular bones of the limbs in adolescents. Usually, the OO is classified based on its localisation. Night-time pain is the major symptom of OO, which is commonly relieved using non-steroidal anti-inflammatory drugs, while surgery is required only for those patients with severe pain or in case of failure of previous conservative treatments. Our case report describes a 56-year-old male basketball player who self-referred to our outpatient physical therapy with a shoulder pain complaint. Considering the anamnesis and the physical examination, the physical therapist referred the patient to an orthopaedic surgeon, who suggested a detailed imaging investigation. The peculiarity of this clinical case is the overlapping of two clinical presentations: the symptomatology of the OO and the concurrent mechanical disorder due to a rotator cuff tendinopathy.

Benign Bone-Forming Tumors.

Benign bone-forming tumors comprise osteomas, osteoid osteomas, and osteoblastomas. Osteomas affect a wide age range and are usually discovered incidentally. They occur predominantly in the craniofacial skeleton and are classically composed of compact bone. Osteoid osteomas and osteoblastomas are painful lesions occurring in young patients. They are morphologically similar and characterized by FOS gene rearrangement and c-FOS expression at a protein level. Osteoid osteomas are usually smaller than 2 cm in maximum dimension with limited growth potential; osteoblastomas are larger than 2 cm and may be locally aggressive. Histologically both are composed of anastomosing trabeculae of woven bone.

Multicentric osteoblastoma-like: report of a rare case in the craniofacial region / Osteoblastoma-like multicêntrico: relato de um caso raro na região craniofacial

ABSTRACT The osteoblastoma-like tumor is a rare condition with limited information about its treatment in the current medical literature. The tumor histologically resembles osteoblastoma, although the imaging features are similar to those seen in primary vascular lesions. Due to the uncertainty in the biological behavior of this tumor and because it is an unusual diagnosis, treatment can be aggressive, such as amputation, en bloc resection, and/or chemotherapy. This work reports a rare case of a patient with multicentric osteoblastoma-like in the craniofacial region, treated aggressively with total resection of the lesions.

RESUMEN El tipo osteoblastoma es una afección poco común y la literatura médica actual tiene información limitada sobre su tratamiento. Es histológicamente similar al osteoblastoma, aunque las características de las imágenes son similares a las que se observan en las lesiones vasculares primarias. Por la incertidumbre de su comportamiento biológico y por tratarse de un diagnóstico poco habitual, el tratamiento puede ser agresivo, con amputación, resección en bloque y/o quimioterapia. Este trabajo reporta un caso raro de osteoblastoma multicéntrico en la región craneofacial, tratado de manera agresiva con resección total de las lesiones.

RESUMO O osteoblastoma-like é uma condição rara, e a literatura médica atual tem informações limitadas sobre seu tratamento. Ele se assemelha histologicamente ao osteoblastoma, embora as características imaginológicas sejam semelhantes às observadas nas lesões vasculares primárias. Devido à incerteza do seu comportamento biológico e por se tratar de um diagnóstico incomum, o tratamento pode ser agressivo, com amputação, ressecção em bloco e/ou quimioterapia. Este trabalho relata um caso raro de osteoblastoma-like multicêntrico em região craniofacial, tratado de forma agressiva com ressecção total das lesões.

Resection of Bone Tumor Guided by Gamma Probe and Evaluation of Postoperative Pain.

Osteoid osteoma is a benign neoplasm commonly found in young men, but that can be found in every age, which affects mainly long bones, clinically characterized by continuous and limiting pain that is relieved by salicylates. It is a small lesion composed of immature osteoid tissue, central hypervascularization and surrounding sclerotic area. Its diagnosis is performed by the clinic and aided by imaging tests, such as common radiography and computed tomography. Radiography shows a central radiolucent lesion and peripheral sclerosis. The biopsy takes place only in cases of diagnostic doubt. Surgical treatment involves resection of the niche, providing greater symptomatic relief, as well as percutaneous techniques. The technique of radioisotope-guided resection has good acceptance in the scientific community for its fast surgical procedure directed to the lesion; however, the percutaneous technique that stands out is radiofrequency ablation. In the present study, all of the patients submitted to the technique presented total improvement of the pain.

Resection of Bone Tumor Guided by Gamma Probe and Evaluation of Postoperative Pain / Ressecção de tumor ósseo guiado por Gamaprobe e avaliação do quadro álgico pós-operatório

Abstract Osteoid osteoma is a benign neoplasm commonly found in young men, but that can be found in every age, which affects mainly long bones, clinically characterized by continuous and limiting pain that is relieved by salicylates. It is a small lesion composed of immature osteoid tissue, central hypervascularization and surrounding sclerotic area. Its diagnosis is performed by the clinic and aided by imaging tests, such as common radiography and computed tomography. Radiography shows a central radiolucent lesion and peripheral sclerosis. The biopsy takes place only in cases of diagnostic doubt. Surgical treatment involves resection of the niche, providing greater symptomatic relief, as well as percutaneous techniques. The technique of radioisotope-guided resection has good acceptance in the scientific community for its fast surgical procedure directed to the lesion; however, the percutaneous technique that stands out is radiofrequency ablation. In the present study, all of the patients submitted to the technique presented total improvement of the pain.

Resumo O osteoma osteóide é uma neoplasia benigna comum em homens jovens; porém, pode atingir qualquer idade, acomete preferencialmente ossos longos, e é caracterizada por dor contínua e limitante que é aliviada por salicilatos. É uma lesão de tamanho pequeno, composta por tecido osteóide imaturo, hipervascularização central e área esclerótica circundante. O diagnóstico é realizado pela clínica e auxiliado por exames de imagem, como radiografia comum e tomografia computadorizada. À radiografia, apresenta-se como uma lesão radiolucente central e esclerose periférica. A biópsia está indicada somente nos casos de dúvida diagnóstica. O tratamento cirúrgico envolve a ressecção do nicho, proporcionando maior alívio sintomático, assim como as técnicas percutâneas. A técnica de ressecção guiada por radioisótopo tem boa aceitação na comunidade científica por tornar o procedimento cirúrgico mais rápido e dirigido para a lesão, ainda que o padrão ouro de tratamento seja a técnica percutânea de ablação por radiofrequência. É válido ressaltar que, no presente estudo, todos os pacientes submetidos à resecção cirúrgica apresentaram regressão do quadro álgico.

Analysis of whole-body bone scintigraphy and SPECT/CT imaging in osteoid osteoma / 中华核医学与分子影像杂志

Objective To analyze features of osteoid osteoma on whole-body bone scan (WBS) and SPECT/CT imaging.Methods From January 2010 to December 2018,70 patients (50 males,20 females,age:4-66 years) with osteoid osteoma confirmed by pathology were enrolled from the Affiliated Hospital of Southwest Medical University.All patients underwent WBS and SPECT/CT imaging and imaging features were retrospectively analyzed.Results A total of 70 lesions were found by WBS combined with SPECT/CT imaging,and 26 lesions (37.1％,26/70) were found in the femur and 25 lesions (35.7％,25/70) in the tibia.The radioactive ratio of target lesion to non-target lesion (T/NT) was 3.7±1.2 in 56 patients who underwent three-phase bone imaging.WBS showed that 48 lesions (68.6％,48/70) were round (or nearly round),21 lesions (30％,21/70) were spindle-shaped,and 1 lesion (1.4％,1/70) was irregular-shaped,while SPECT/CT imaging showed that 69 lesions (98.6％,69/70) were round (or round) and 1 lesion (1.4％,1/70) was irregular-shaped.The "double-density sign" was found in 48 lesions (68.6％,48/70) by WBS and in 59 lesions (84.3％,59/70) by SPECT/CT imaging.SPECT/CT imaging detected nidus in 59 lesions (84.3％,59/70) and calcification or ossification ("target sign") in 27 lesions (38.6％,27/70).Conclusion The typical features of osteoid osteoma on WBS and SPECT/CT imaging include "double density sign",nidus and "target sign",which contribute to the diagnosis of osteoid osteoma.

Analysis of whole-body bone scintigraphy and SPECT/CT imaging in osteoid osteoma / 中华核医学与分子影像杂志

Objective@#To analyze features of osteoid osteoma on whole-body bone scan (WBS) and SPECT/CT imaging.@*Methods@#From January 2010 to December 2018, 70 patients (50 males, 20 females, age: 4-66 years) with osteoid osteoma confirmed by pathology were enrolled from the Affiliated Hospital of Southwest Medical University. All patients underwent WBS and SPECT/CT imaging and imaging features were retrospectively analyzed.@*Results@#A total of 70 lesions were found by WBS combined with SPECT/CT imaging, and 26 lesions (37.1%, 26/70) were found in the femur and 25 lesions (35.7%, 25/70) in the tibia. The radioactive ratio of target lesion to non-target lesion (T/NT) was 3.7±1.2 in 56 patients who underwent three-phase bone imaging. WBS showed that 48 lesions (68.6%, 48/70) were round (or nearly round), 21 lesions (30%, 21/70) were spindle-shaped, and 1 lesion (1.4%, 1/70) was irregular-shaped, while SPECT/CT imaging showed that 69 lesions (98.6%, 69/70) were round (or round) and 1 lesion (1.4%, 1/70) was irregular-shaped. The " double-density sign" was found in 48 lesions (68.6%, 48/70) by WBS and in 59 lesions (84.3%, 59/70) by SPECT/CT imaging. SPECT/CT imaging detected nidus in 59 lesions (84.3%, 59/70) and calcification or ossification (" target sign" ) in 27 lesions (38.6%, 27/70).@*Conclusion@#The typical features of osteoid osteoma on WBS and SPECT/CT imaging include " double density sign" , nidus and " target sign" , which contribute to the diagnosis of osteoid osteoma.

Chronic Back Pain Diagnosed as Giant Osteoid Osteoma of the Thoracic Vertebra: A Case Report.

INTRODUCTION: Diagnosing an osteoid osteoma as a benign tumor can be challenging owing to its different presentation patterns, ambiguous radiological findings and unusual sites of involvement. The present case report involves a 30-year-old female patient with a large osteoid osteoma of the thoracic vertebrae as an uncommon site of its presentation. CASE PRESENTATION: The patient presented with a one-year history of progressive right-sided upper back and interscapular pains. She was identified as a candidate for surgery using the whole body bone scan and a multiple detector computed tomography (MDCT) scan. A large 25-mm osteoid osteoma of the lamina of the third thoracic vertebra (T3) was also diagnosed through histopathology. CONCLUSION: As a potential cause of persistent back pain in young adults, an osteoid osteoma may be easily missed by routine radiographs. The CT scan is an effective tool in the investigation of the size and location of this tumor. Surgical excision can also be used for treating spinal lesions.

Radiofrequency ablation of osteoid osteoma: Aiming for excellent outcomes in an Australasian context.

INTRODUCTION: To report a series of patients with osteoid osteoma treated by radiofrequency ablation in whom no complications or recurrences occurred. METHODS: Over a 13-year period, 32 consecutive patients with osteoid osteoma were treated by radiofrequency ablation in an Australasian teaching centre. RESULTS: All patients had resolution of symptoms with no complication or recurrence. CONCLUSIONS: This series is further evidence for the use of radiofrequency ablation as the primary treatment for osteoid osteoma.

The usefulness of chemical-shift magnetic resonance imaging for the evaluation of osteoid osteoma.

OBJECTIVE: The purpose of this study was to determine whether chemical-shift magnetic resonance imaging (MRI) could be useful in the diagnosis of osteoid osteoma when clinical and radiological tumor features are inconclusive. MATERIALS AND METHODS: This retrospective study included 17 patients who underwent chemical-shift MRI for the evaluation of osteoid osteoma. For all patients, two musculoskeletal radiologists independently recorded signal intensities on in-phase and out-of-phase images in the nidus of the tumor, in abnormal-intensity bone marrow surrounding the lesion, and in normal-appearing bone marrow. For each region, relative signal intensity ratios were calculated by dividing out-of-phase by in-phase values. Relative ratios > 1 were considered indicative of neoplastic lesions. Statistical analysis was carried out to analyze the sample. Inter-observer and intra-observer agreement for each imaging method were assessed using intraclass correlation coefficients according to the Fleiss method and a value > 0.65 was considered to indicate substantial agreement. RESULTS: The mean relative signal intensity ratios were 1.2 (range, 0.9-1.4) for the nidus and 0.35 (range, 0.11-0.66) for the surrounding tissue; these values differed significantly from the relative signal-intensity ratios for normal-appearing bone marrow (p < 0.05). CONCLUSION: Chemical-shift MRI is useful for the diagnosis and evaluation of osteoid osteoma.

The usefulness of chemical-shift magnetic resonance imaging for the evaluation of osteoid osteoma / O uso da sequência T1 em fase e fora de fase da ressonância magnética para a avaliação do osteoma osteoide

Abstract Objective: The purpose of this study was to determine whether chemical-shift magnetic resonance imaging (MRI) could be useful in the diagnosis of osteoid osteoma when clinical and radiological tumor features are inconclusive. Materials and Methods: This retrospective study included 17 patients who underwent chemical-shift MRI for the evaluation of osteoid osteoma. For all patients, two musculoskeletal radiologists independently recorded signal intensities on in-phase and out-of-phase images in the nidus of the tumor, in abnormal-intensity bone marrow surrounding the lesion, and in normal-appearing bone marrow. For each region, relative signal intensity ratios were calculated by dividing out-of-phase by in-phase values. Relative ratios > 1 were considered indicative of neoplastic lesions. Statistical analysis was carried out to analyze the sample. Inter-observer and intra-observer agreement for each imaging method were assessed using intraclass correlation coefficients according to the Fleiss method and a value > 0.65 was considered to indicate substantial agreement. Results: The mean relative signal intensity ratios were 1.2 (range, 0.9-1.4) for the nidus and 0.35 (range, 0.11-0.66) for the surrounding tissue; these values differed significantly from the relative signal-intensity ratios for normal-appearing bone marrow (p < 0.05). Conclusion: Chemical-shift MRI is useful for the diagnosis and evaluation of osteoid osteoma.

Resumo Objetivo: O objetivo deste estudo foi determinar se a sequência T1 em fase e fora de fase da ressonância magnética (RM) poderia ser útil no diagnóstico de osteoma osteoide em situações nas quais características clínicas e radiológicas são indefinidas. Materiais e Métodos: Este estudo retrospectivo incluiu 17 pacientes submetidos a RM para avaliação do osteoma osteoide. Em todos os pacientes, dois radiologistas musculoesqueléticos registraram, independentemente, as intensidades de sinal em imagens em fase e fora de fase no nidus do tumor, na medula óssea de intensidade anormal ao redor da lesão e na medula óssea de aspecto normal. Para cada região, as relações de intensidade de sinal relativas foram calculadas dividindo os valores na sequência fora de fase pelos valores em fase. Razões relativas > 1 foram consideradas indicativas de lesões neoplásicas. A análise estatística foi realizada para analisar a amostra. A concordância interobservador e intraobservador para cada método de imagem foi avaliada por meio dos coeficientes de correlação intraclasse, segundo o método de Fleiss, e considerou-se um valor > 0,65 para indicar concordância substancial. Resultados: As razões de intensidade de sinal relativa média foram 1,2 (variação: 0,9-1,4) para o nidus e 0,35 (variação: 0,11-0,66) para o tecido circundante. Estes valores diferiram significativamente das relações de sinal-intensidade relativa da medula óssea com aspecto normal (p < 0,05). Conclusão: A sequência em fase e fora de fase da RM mostrou-se útil para o diagnóstico e avaliação do osteoma osteoide.

Case of Spinal Osteoblastoma in Elderly: Is It Really a Young Patient's Disease?

BACKGROUND: Osteoblastoma is a benign bone-forming tumor, sometimes locally invasive, that may involve any bone. The highest incidence is between 20 and 30 years of age, and there are no cases described in the elderly. METHODS: We report a case of an elderly patient with a lesion in the lumbar spine in which osteoblastoma diagnosis was made. CONCLUSIONS: Osteoblastoma is a rare tumor older than 50 years of age, but it should be considered in the differential diagnosis of bone lesions of the spine in adulthood and in the elderly, to avoid a delay in the treatment.

Neurophysiological Monitoring in Radiofrequency Ablation of Spinal Osteoid Osteoma With a Progressive Time and Temperature Protocol in Children.

STUDY DESIGN: Retrospective. Level IV Evidence. OBJECTIVE: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children. SUMMARY AND BACKGROUND DATA: To our knowledge, this is the first case series of spinal OO in pediatric patients treated at a single center employing IONM during RFA. METHODS: This is a retrospective study of seven consecutive patients (3 girls and 4 boys, mean age: 9 years 4 months) with imaging and clinical signs compatible with spinal OO who underwent CT-guided RFA, under general anesthesia, and IONM in a single center between 2011 and 2015. Before the RFA procedure, a CT-guided percutaneous biopsy of the nidus was performed in the same setting. RFA was divided into four cycles of increasing time and temperature and performed under IONM in every patient. RESULTS: Two patients had lesions located in the thoracic spine and five patients had lumbar involvement. The RFA technical and clinical success was 85.7%. Six patients presented with reversible neurophysiological changes either during biopsy needle positioning or RFA cycles. In the remaining case, as IONM changes did not improve after several minutes of neuroprotective hypertension, the procedure was interrupted. Neither neurologic nor vascular complications were observed after RFA treatment. In only one biopsy sample, OO was confirmed by histopathologic studies. CONCLUSION: CT-guided RFA is an accepted minimally invasive technique for the treatment of spinal OO in children. IONM may be a helpful tool that requires minimal additional time and provides feedback on the state of the spinal cord and nerves at risk during the procedure. We promote the use of IONM during these procedures to detect and possibly prevent impending neurologic damage. LEVEL OF EVIDENCE: Level IV.

Percutaneous radiofrequency ablation for osteoid osteoma under guidance of threedimensional fluoroscopy.

PURPOSE: To evaluate the outcome of percutaneous radiofrequency ablation under guidance of 3-dimensional fluoroscopy in 17 patients with osteoid osteoma. METHODS: Records of 11 male and 6 female consecutive patients aged 4 to 28 (mean, 13.8) years who underwent radiofrequency ablation under guidance of 3-dimensional fluoroscopy for osteoid osteoma and were followed up for a mean of 15.8 (range, 12-28) months were reviewed. All patients had been treated with analgesics but failed to achieve lasting pain relief. Visual analogue score (VAS) for pain was assessed pre- and post-operatively. Absence of pain was considered recovery. RESULTS: The mean operating time was 55 (range, 20-95) minutes, and the mean length of hospital stay was 2.8 (range, 2-7) days. The mean amount of radiation was 390.2 (range, 330.5-423.6) mGy/cm. Relief of pain occurred within the first 24 hours in 11 patients and by the end of the first week in 3 patients. Pain persisted in 3 patients at one month; they underwent revision surgery and achieved complete recovery. The mean VAS for pain was 7.2 (range, 6-9) in 17 patients preoperatively and decreased to 0.64 (range, 0-2) in the 14 patients with pain relief and 0.66 (range, 0-1) in the 3 patients after revision surgery. Two patients had severe discharge from the wound secondary to fat necrosis, which resolved within a week with antibiotics and local dressings. No patient had cellulitis, vasomotor instability, neurovascular injury, fracture, or deep infection. CONCLUSION: Percutaneous radiofrequency ablation under guidance of 3-dimensional fluoroscopy is a viable treatment option for osteoid osteoma.

Effectiveness of Computed Tomography Guided Percutaneous Radiofrequency Ablation Therapy for Osteoid Osteoma: Initial Results and Review of the Literature.

BACKGROUND: The aim of this retrospective study is to determine our experience of technique success rate, complications and clinical results in long term follow up for computed tomography (CT)-guided radiofrequency ablation [RA] therapy for osteoid osteoma (OO). MATERIAL/METHODS: We performed RA therapy to 18 patients with OO referred to interventional radiology from other clinics primarily from orthopedics; between January 2011 to May 2014. Daytime and nighttime pain intensity of 18 patients was noted according to visual analog scale (VAS). After procedure pain intensity was compared with before one. We also discussed other factors can affect it. RESULTS: All procedures were completed technically successful for all patients [100%]. We did not experience any major complication or mortality. However we had 3 minor complications. Pain came back in 1 patient after 5 months from procedure and it was considered as recurrence. Dramatic pain intensity fall was seen in patients after procedure, both daytime and nighttime. However we did not find and statistically significant change in comparison of pain intensity reduce and time needed to return back to routine life when using patients demographic data and lesion size. CONCLUSIONS: CT guided RA therapy of OO is minimally invasive, effective and secure procedure.

Computed tomography-guided percutaneous trephine removal of the nidus in osteoid osteoma patients: experience of a single center in Brazil.

OBJECTIVE: To report the results of computed tomography (CT)-guided percutaneous resection of the nidus in 18 cases of osteoid osteoma. MATERIALS AND METHODS: The medical records of 18 cases of osteoid osteoma in children, adolescents and young adults, who underwent CT-guided removal of the nidus between November, 2004 and March, 2009 were reviewed retrospectively for demographic data, lesion site, clinical outcome and complications after procedure. RESULTS: Clinical follow-up was available for all cases at a median of 29 months (range 6-60 months). No persistence of pre-procedural pain was noted on 17 patients. Only one patient experienced recurrence of symptoms 12 months after percutaneous resection, and was successfully retreated by the same technique, resulting in a secondary success rate of 18/18 (100%). CONCLUSION: CT-guided removal or destruction of the nidus is a safe and effective alternative to surgical resection of the osteoid osteoma nidus.

OBJETIVO: Avaliar os resultados da ressecção percutânea do nidus guiada por tomografia computadorizada em 18 casos de osteoma osteoide. MATERIAIS E MÉTODOS: Os prontuários médicos de 18 crianças, adolescentes e adultos jovens diagnosticados com osteoma osteoide e submetidos a ressecção percutânea do nidus guiada por TC, entre novembro de 2004 e março de 2009, foram revisados retrospectivamente para coleta de dados demográficos, local da lesão, evolução clínica e complicações após o procedimento. RESULTADOS: A mediana de tempo de seguimento de todos os pacientes foi 29 meses (intervalo de 6­60 meses). Dezessete pacientes não apresentaram recorrência da dor no pós-operatório. Apenas um paciente teve recorrência dos sintomas 12 meses após a ressecção percutânea e foi retratado com sucesso, pela mesma técnica, resultando numa taxa de sucesso secundário de 18/18 (100%). CONCLUSÃO: A ressecção guiada por tomografia computadorizada do nidus é uma alternativa segura e eficaz para a ressecção cirúrgica do nidus em pacientes com osteoma osteoide.

Computed tomography-guided percutaneous trephine removal of the nidus in osteoid osteoma patients: experience of a single center in Brazil / Remoção percutânea guiada por tomografia computadorizada do nidus em paciente com osteoma osteoide: experiência de um único centro no Brasil

AbstractObjective:To report the results of computed tomography (CT)-guided percutaneous resection of the nidus in 18 cases of osteoid osteoma.Materials and Methods:The medical records of 18 cases of osteoid osteoma in children, adolescents and young adults, who underwent CT-guided removal of the nidus between November, 2004 and March, 2009 were reviewed retrospectively for demographic data, lesion site, clinical outcome and complications after procedure.Results:Clinical follow-up was available for all cases at a median of 29 months (range 6–60 months). No persistence of pre-procedural pain was noted on 17 patients. Only one patient experienced recurrence of symptoms 12 months after percutaneous resection, and was successfully retreated by the same technique, resulting in a secondary success rate of 18/18 (100%).Conclusion:CT-guided removal or destruction of the nidus is a safe and effective alternative to surgical resection of the osteoid osteoma nidus.

ResumoObjetivo:Avaliar os resultados da ressecção percutânea do nidus guiada por tomografia computadorizada em 18 casos de osteoma osteoide.Materiais e Métodos:Os prontuários médicos de 18 crianças, adolescentes e adultos jovens diagnosticados com osteoma osteoide e submetidos a ressecção percutânea do nidus guiada por TC, entre novembro de 2004 e março de 2009, foram revisados retrospectivamente para coleta de dados demográficos, local da lesão, evolução clínica e complicações após o procedimento.Resultados:A mediana de tempo de seguimento de todos os pacientes foi 29 meses (intervalo de 6–60 meses). Dezessete pacientes não apresentaram recorrência da dor no pós-operatório. Apenas um paciente teve recorrência dos sintomas 12 meses após a ressecção percutânea e foi retratado com sucesso, pela mesma técnica, resultando numa taxa de sucesso secundário de 18/18 (100%).Conclusão:A ressecção guiada por tomografia computadorizada do nidus é uma alternativa segura e eficaz para a ressecção cirúrgica do nidus em pacientes com osteoma osteoide.