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

Karagöz E, Özel D, Özkan F, Özel BD, Özer Ö, Coşkun ZÜ - Pol J Radiol (2016)

Bottom Line: After procedure pain intensity was compared with before one.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.CT guided RA therapy of OO is minimally invasive, effective and secure procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Ablation of an osteoid osteoma of the left proximal metaphyseal tibia. (A) CT scan demonstrates the nidus [arrow] of the osteoid osteoma. (B) During ablation procedure the tiny RF ablation probe being inserted into the nidus through a needle. (C) After the procedure.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4920061&req=5

f1-poljradiol-81-295: Ablation of an osteoid osteoma of the left proximal metaphyseal tibia. (A) CT scan demonstrates the nidus [arrow] of the osteoid osteoma. (B) During ablation procedure the tiny RF ablation probe being inserted into the nidus through a needle. (C) After the procedure.

Mentions: After diagnosis confirmed, all patients were informed about RA and other treatment methods. Before procedure protrombin time and (international normalized ratio) INR values were controlled. Patients were starved for 12 hours. Whole blood count, allergy and anesthesia status were controlled. VAS of daytime and nighttime were noted. Procedure was performed under general anesthesia in CT unit and aseptic conditions. Localization was confirmed with CT scan (Sensation 40, Siemens Medical Solutions, Forcheim, Germany) after placement of multiple radiopac skin signer. KV and MAs values were chosen according to ALARA (as low as reasonably achievable) principle to minimize ionizing radiation exposure. After the entrance point signed with a pen, surrounding area was cleaned with iodine based antiseptic solution. Local anesthetic administered from entrance point to bone cortex. Skin cut was created. From this skin cut bone penetration canule (RITA StarBust Access System, 11G, AngioDynamics, Inc., USA) was advanced and cortex was penetrated with a hammer in case of necessary. After canule reached to nidus it was replaced with RFA electrode (UniBlate, AngioDynamics, Inc., USA) (Figure 1). Grounding pads and electrode were connected to generator (RITA 1500X, AngioDynamics, Inc., USA). Generator was set up to provide 77–90°C in 2–3 minutes. Procedure was performed around 90°C and 4–6 minutes. After procedure canule and electrode removed. IV parasetamol was administrated to control pain, as a result of released prostaglandins with nidus ablation. NSAIDs use was recommended for 3 days. All patients followed up in orthopedics clinic for one night. If there was no complication patients were externed. Heavy exercises forbidden to patients have lesion in weight bearing bones. All patients were called for follow up after one week, one month and six months after procedure. VAS values were obtained after procedure rather with follow up or telephone communication. Time to return back normal daily activity was also noted.


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

Karagöz E, Özel D, Özkan F, Özel BD, Özer Ö, Coşkun ZÜ - Pol J Radiol (2016)

Ablation of an osteoid osteoma of the left proximal metaphyseal tibia. (A) CT scan demonstrates the nidus [arrow] of the osteoid osteoma. (B) During ablation procedure the tiny RF ablation probe being inserted into the nidus through a needle. (C) After the procedure.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4920061&req=5

f1-poljradiol-81-295: Ablation of an osteoid osteoma of the left proximal metaphyseal tibia. (A) CT scan demonstrates the nidus [arrow] of the osteoid osteoma. (B) During ablation procedure the tiny RF ablation probe being inserted into the nidus through a needle. (C) After the procedure.
Mentions: After diagnosis confirmed, all patients were informed about RA and other treatment methods. Before procedure protrombin time and (international normalized ratio) INR values were controlled. Patients were starved for 12 hours. Whole blood count, allergy and anesthesia status were controlled. VAS of daytime and nighttime were noted. Procedure was performed under general anesthesia in CT unit and aseptic conditions. Localization was confirmed with CT scan (Sensation 40, Siemens Medical Solutions, Forcheim, Germany) after placement of multiple radiopac skin signer. KV and MAs values were chosen according to ALARA (as low as reasonably achievable) principle to minimize ionizing radiation exposure. After the entrance point signed with a pen, surrounding area was cleaned with iodine based antiseptic solution. Local anesthetic administered from entrance point to bone cortex. Skin cut was created. From this skin cut bone penetration canule (RITA StarBust Access System, 11G, AngioDynamics, Inc., USA) was advanced and cortex was penetrated with a hammer in case of necessary. After canule reached to nidus it was replaced with RFA electrode (UniBlate, AngioDynamics, Inc., USA) (Figure 1). Grounding pads and electrode were connected to generator (RITA 1500X, AngioDynamics, Inc., USA). Generator was set up to provide 77–90°C in 2–3 minutes. Procedure was performed around 90°C and 4–6 minutes. After procedure canule and electrode removed. IV parasetamol was administrated to control pain, as a result of released prostaglandins with nidus ablation. NSAIDs use was recommended for 3 days. All patients followed up in orthopedics clinic for one night. If there was no complication patients were externed. Heavy exercises forbidden to patients have lesion in weight bearing bones. All patients were called for follow up after one week, one month and six months after procedure. VAS values were obtained after procedure rather with follow up or telephone communication. Time to return back normal daily activity was also noted.

Bottom Line: After procedure pain intensity was compared with before one.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.CT guided RA therapy of OO is minimally invasive, effective and secure procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus