Radiofrequency ablation safe and effective for osteoid osteoma
Monday, 29 November 1999 19:00 | 
| Medicexchange News - Medicexchange News |
Osteoid osteomas -- benign tumors of the bone that are extremely painful -- can be quickly and safely burned away by radiofrequency ablation, according to a new study.
Osteoid osteomas -- benign tumors of the bone that are extremely painful -- can be quickly and safely burned away by radiofrequency ablation, according to a report this week at the 32nd Annual Scientific Meeting of the Society of Interventional Radiology in Seattle. And the outpatient procedure can relieve pain within hours.
"Even though they are very small, usually less than a centimeter in diameter, osteomas are packed with nerve fibers and blood vessels, which makes them exquisitely tender, out of proportion to the size of lesion," Dr. Eran Hayeems, based at the University Health Network and Mount Sinai Hospital in Toronto, told Reuters Health.
Radiofrequency ablation has been used on osteoid osteomas for about 6 or 7 years now, the presenter noted. Before that, the only treatment was "orthopedic surgery, in which the surgeon would make a large incision and carve out this tumor," he added. "It is not an insignificant operation, and requires weeks or months of rehabilitation."
With minimally invasive radiofrequency ablation, on the other hand, "the patient walks out of the hospital the same day," he continued.
Dr. Hayeems presented outcomes data of patients in his practice with osteoid osteomas treated with radiofrequency ablation. Between 2004 and 2006, they treated 27 lesions in 26 patients. Osteomas typically occur in long bones of relatively young people, but the age range of his cohort was 17 to 62 years old (mean 29 years).
The procedures were performed using computed tomographic imaging to pinpoint the precise location of the tumor. Probe tips were placed at the center of the tumors.
All of the procedures were technically successful, he reported, and there were no complications. Pain was totally gone in all but three of the patients.
In one of those who still had pain, gadolinium-enhanced magnetic resonance imaging revealed enhancement of the nidus, indicating that part of the osteoma remained. She was retreated, and her symptoms "immediately resolved."
"Early on in our experience, we only inserted probes once into the center of the tumor. But the probes can only heat a certain radius of tissue," Dr. Hayeems explained. Currently, any lesion larger than 1 cm is treated at two locations to ensure that all of the tissue is removed away.
Although "the overwhelming majority of osteoid osteomas can be dealt with percutaneously," the physician noted, some patients will still require surgical treatment if their lesion is "right beside a nerve or blood vessel."
Moreover, "for osteomas in the spine and within 1 cm of the spinal cord or exiting nerve roots, the consensus is to send that patient to an orthopedic surgeon.
"Even though they are very small, usually less than a centimeter in diameter, osteomas are packed with nerve fibers and blood vessels, which makes them exquisitely tender, out of proportion to the size of lesion," Dr. Eran Hayeems, based at the University Health Network and Mount Sinai Hospital in Toronto, told Reuters Health.
Radiofrequency ablation has been used on osteoid osteomas for about 6 or 7 years now, the presenter noted. Before that, the only treatment was "orthopedic surgery, in which the surgeon would make a large incision and carve out this tumor," he added. "It is not an insignificant operation, and requires weeks or months of rehabilitation."
With minimally invasive radiofrequency ablation, on the other hand, "the patient walks out of the hospital the same day," he continued.
Dr. Hayeems presented outcomes data of patients in his practice with osteoid osteomas treated with radiofrequency ablation. Between 2004 and 2006, they treated 27 lesions in 26 patients. Osteomas typically occur in long bones of relatively young people, but the age range of his cohort was 17 to 62 years old (mean 29 years).
The procedures were performed using computed tomographic imaging to pinpoint the precise location of the tumor. Probe tips were placed at the center of the tumors.
All of the procedures were technically successful, he reported, and there were no complications. Pain was totally gone in all but three of the patients.
In one of those who still had pain, gadolinium-enhanced magnetic resonance imaging revealed enhancement of the nidus, indicating that part of the osteoma remained. She was retreated, and her symptoms "immediately resolved."
"Early on in our experience, we only inserted probes once into the center of the tumor. But the probes can only heat a certain radius of tissue," Dr. Hayeems explained. Currently, any lesion larger than 1 cm is treated at two locations to ensure that all of the tissue is removed away.
Although "the overwhelming majority of osteoid osteomas can be dealt with percutaneously," the physician noted, some patients will still require surgical treatment if their lesion is "right beside a nerve or blood vessel."
Moreover, "for osteomas in the spine and within 1 cm of the spinal cord or exiting nerve roots, the consensus is to send that patient to an orthopedic surgeon.
