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Percutaneous radiofrequency ablation for spinal osteoid osteoma and osteoblastoma

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Abstract

Purposes

We sought to verify the efficacy and safety of RFA in spinal OO and osteoblastomas (OB) (Enneking Stage 2, S2).

Methods

We retrospectively reviewed patients treated in our hospital. Surgical resection was indicated for Enneking Stage 3 OB. RFA indications for spinal OO and OB (S2) were no neurological deficits, complete bone cortex around the lesion on computed tomography (CT), and cerebrospinal fluid between a lesion and the spinal cord/nerve root on magnetic resonance imaging. Abundant cerebrospinal fluid (more than 1.0 mm) between the lesion and nerve root/spinal cord was preferred to prevent neurological damage by heat. Otherwise, surgery was recommended. The minimum follow-up was 24 months.

Results

Ten patients were treated with CT-guided percutaneous RFA, including three with OB and seven with OO. No patients had neurological deficits or scoliosis. In OO patients, the average visual analog scale (VAS) scores were 7.6/10 (range 6–10) before RFA. In OB cases, the VAS scores were 8, 7, and 9 before RFA. Nine patients had a one-stage biopsy and then RFA, and one patient had a two-stage procedure (biopsy before RFA). The average RFA time for OO was 10 min (range 4–12). In the three OB cases, the RFA time was 12, 12, and 24 min. The time of the whole produce was 98 min (range 65–130 min). All 10 patients were followed-up. The average follow-up time of OO was 46.6 months (range 24–66). Six patients were free of pain, except one who suffered occasional pain with VAS 2/10. The three OB cases were free of pain at 24, 26, and 26 months.

Conclusion

CT-guided percutaneous RFA is a safe and effective treatment for spinal OO and S2 OB, especially in lesions with no neurological deficits and intact cortical bone. Cerebrospinal fluid around the lesion is an appropriate indication for percutaneous RFA.

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Author notes

  1. Ben Wang and Song Bo Han contribute equally to this work.

Authors and Affiliations

  1. Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China

    Ben Wang, Liang Jiang, Zhong Jun Liu & Xiao Guang Liu

  2. Peking University Health Science Center, No. 38 XuanYuan Road, Haidian District, Beijing, 100191, China

    Ben Wang

  3. Department of Radiology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China

    Song Bo Han, Hui Shu Yuan & Chen Liu

  4. Pain Medicine Centre, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China

    Bin Zhu

  5. Department of Interventional Therapy, Beijing Cancer Hospital, No. 69 Wanfeng Road, Fengtai District, Beijing, 100142, China

    Chen Liu

Authors
  1. Ben Wang
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  2. Song Bo Han
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  3. Liang Jiang
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  4. Hui Shu Yuan
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  5. Chen Liu
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  6. Bin Zhu
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  7. Zhong Jun Liu
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  8. Xiao Guang Liu
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Corresponding authors

Correspondence to Liang Jiang or Xiao Guang Liu.

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Conflict of interest

Author LJ has received grants from Peking University Third Hospital. There is no other conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Funding

This study was funded by Peking University Third Hospital (Y71508-01).

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Wang, B., Han, S.B., Jiang, L. et al. Percutaneous radiofrequency ablation for spinal osteoid osteoma and osteoblastoma. Eur Spine J 26, 1884–1892 (2017). https://doi.org/10.1007/s00586-017-5080-0

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  • DOI: https://doi.org/10.1007/s00586-017-5080-0

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