Osteoid Osteoma Ablation
Osteoid osteoma is a relatively common, benign but painful bone tumor that occurs mainly in children and young adults. We treat most patients with osteoid osteomas using a minimally invasive, image-guided procedure called radiofrequency ablation. During this procedure we direct a probe into the tumor and heat it up for several minutes using radiofrequency energy, which destroys it. Most patients experience complete pain relief within the first few days after the procedure. Unlike open surgery for these tumors, ablation causes minimal damage to the bone and surrounding muscle. Ablation is also a promising treatment for patients who have persistent or recurrent pain after surgical treatment for osteoid osteoma.
How do I get ready for the procedure?
On the night before the procedure eat a light meal, then do not eat or drink anything after midnight. We will provide you with more detailed information about which medications you may take in days before and on the morning of the procedure. Plan to have someone drive you home after the procedure.
What will happen during the procedure?
Because of the painful nature of the tumor and its location in bone, we perform radiofrequency ablation under general anesthesia. After the area above the tumor is numbed we advance a cannula, a hollow needle, to the tumor, and ensure that it is correctly positioned with a CT scan. We then insert a bone drill through the cannula and use it to penetrate the tumor’s surface, again ensuring its correct positioning with a CT scan. After withdrawing the drill, we use a biopsy needle to remove a fragment of the osteoma, and a pathologist examines it to verify its identity. We then advance the radiofrequency probe through the cannula into the center of tumor, and heat it to 85-90 C for several minutes. We then remove both the probe and cannula. The entire procedure takes approximately two to three hours.
Are there any risks?
Radiofrequency ablation is a very safe procedure with few complications; they include the possibility of a mild skin burn induced by heat. Other potential complications include bleeding and infection at the skin entry site.
After the procedure
After the procedure we will monitor you in the recovery room for about four hours, then you may return home. You are likely to have pain and require pain medication on the day of the procedure, but the pain should recede in the following 72 hours, and most patients are free of pain after one week. Within the first week after the procedure most patients return to their normal activities, although we recommend that you avoid vigorous exercise for three months. About 10 to 20 percent of patients have a recurrence of the tumor, and you may require a second ablation procedure.