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Clinical long-term outcome, technical success, and cost analysis of radiofrequency ablation for the treatment of osteoblastomas and spinal osteoid osteomas in comparison to open surgical resection

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Abstract

Objective

To assess the clinical success and costs of computed tomography (CT)-guided radiofrequency ablation (RFA) of osteoblastoma (OB) and spinal osteoid osteoma (OO).

Materials and methods

Nineteen patients with OB and eight patients with spinal OO were treated with CT-guided RFA. The OBs were localized in the extremities (n = 10), the vertebral column (n = 2), and (juxta-)articular (n = 7). Dedicated procedural techniques included three-dimensional CT-guided access planning in all cases, overlapping RFA needle positions (median, two positions; range, 1–6 RF-electrode positions) within the OB nidus (multiple ablation technique, n = 15), and thermal protection in case of adjacent neural structure in four spinal OO. The data of eight operated OB and ten operated spinal OO patients were used for comparison. Long-term success was assessed by clinical examination and using a questionnaire sent to all operated and RFA-treated patients including visual analogue scales (VAS) regarding the effect of RFA on severity of pain and limitations of daily activities (0–10, with 0 = no pain/limitation up to 10 = maximum or most imaginable pain/limitation).

Results

All patients had a clear and persistent pain reduction until the end of follow-up. The mean VAS score for all spinal OO patients and all OB patients treated either with RFA or with surgical excision significantly decreased for severity of pain at night, severity of pain during the day, and both for limitations of daily and of sports activities.

Conclusions

RFA is an efficient method for treating OB and spinal OO and should be regarded as the first-line therapy after interdisciplinary individual case discussion.

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Acknowledgments

The authors very much thank Professor Volker Ewerbeck, Heidelberg, for supporting this work and his fruitful comments. Also, we thank Dr. Wolfram Stiller, Heidelberg, for his help with calculating the radiation exposure of the CT-guided radiofrequency ablation.

Conflict of interest

No conflict of interest.

Author information

Authors and Affiliations

  1. Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Marc-André Weber, Simon David Sprengel, Hans-Ulrich Kauczor & Christoph Rehnitz

  2. Division of Spine Surgery, Clinic of Orthopedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany

    Georg W. Omlor & Bernd Wiedenhöfer

  3. Division of Orthopedic Oncology, Clinic of Orthopedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany

    Burkhard Lehner

Authors
  1. Marc-André Weber
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  7. Christoph Rehnitz
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Correspondence to Marc-André Weber.

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Weber, MA., Sprengel, S.D., Omlor, G.W. et al. Clinical long-term outcome, technical success, and cost analysis of radiofrequency ablation for the treatment of osteoblastomas and spinal osteoid osteomas in comparison to open surgical resection. Skeletal Radiol 44, 981–993 (2015). https://doi.org/10.1007/s00256-015-2139-z

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  • DOI: https://doi.org/10.1007/s00256-015-2139-z

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