Percutaneous radiofrequency coagulation of osteoid osteoma of the “Neural Spinal Ring”

Study Design: Three cases of osteoid osteomas of the spine, adjacent to neural elements, were treated with CT-guided thermal coagulation. Objective: To present an alternative method to conventional treatment of spinal osteoid osteoma. Summary of Background Data: Percutaneous CT-guided radiofrequency coagulation has been succesfully used for osteoid osteoma of the extremities. The conventional management of spinal osteoid osteoma is by surgical resection. Method: Three patients with osteoid osteoma of the spine, adjacent to neural structures, were treated by percutaneous radiofrequency ablation. The procedure was performed in the CT room under general anesthesia and CT guidance. The thermocoagulation electrode was heated at 90°C for 4 min. Results: Two patients left the hospital the same day; the third one was kept 24 h for observation. All of them had total pain relief within 48 h following the procedure. No complications were recorded. There was no evidence of recurrence after a mean follow-up period of 17 months. Conclusion: Osteoid osteoma of the spine, adjacent to neural structures, can effectively and safely be treated by minimally invasive percutaneous CT guided radiofrequency coagulation.