Clinical Outcomes of Percutaneous Ablative Therapy for Osteoid Osteoma in a Tertiary Care Hospital of LMIC.

Abstract

Introduction:

Osteoid osteoma (OO) is a benign bone tumour producing intense pain due to high levels of prostaglandins. Various treatment options exist for its management, including the use of non-steroidal anti-inflammatory drugs, surgical excision and minimally invasive percutaneous ablation with radiofrequency ablation (RFA) or Microwave ablation (MWA).

Objective:

The purpose of this study was to determine the clinical outcomes of OO treated with percutaneous ablation using RFA and MWA techniques by determining their clinical and technical success.

Methodology:

This retrospective case series was performed at Rehman Medical Institute, Peshawar, Pakistan, from July 2017 to August 2023. All patients presenting with OO diagnosed on imaging, no prior surgical treatment for the lesion, amenable to percutaneous ablation technique with a minimum of 12 months’ follow-up post procedure, were included in the study. All the patients had grading of pain, pre- and post-treatment with visual analogue score (VAS), and complications both pre- and postoperatively were recorded, along with a minimal follow-up of 12 months, along with the need for any further surgical treatment.

Results:

In total, 9 cases were included in this study, with only one being female and a mean age for the cohort of 21 years (SD=5). The mean pretreatment VAS score of the cohort was 7.4 (SD=1.7). In all the cases, 100% technical success was achieved. Most of the patients reported no pain at 12-month follow-up, and only 2 reported mild residual discomfort (VAS 1) at 1-year follow-up. One patient had a recurrence with RFA and was subsequently treated with MWA with no further recurrence, with a reported success rate for the whole cohort of 87.5%.

Conclusion:

In conclusion, this study confirms that CT-guided percutaneous ablative technique is a minimally invasive, reliable and safely reproducible technique for the management of OO.