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Neuroradiology

, Volume 61, Issue 8, pp 935–942 | Cite as

European multicentre study on technical success and long-term clinical outcome of radiofrequency ablation for the treatment of spinal osteoid osteomas and osteoblastomas

  • Thomas BeyerEmail author
  • Carla S. P. van Rijswijk
  • Jose Martel Villagrán
  • Christoph Rehnitz
  • Mario Muto
  • Christian von Falck
  • Jan Gielen
  • Kolja M. Thierfelder
  • Marc-André Weber
Interventional Neuroradiology

Abstract

Purpose

To evaluate technical success and long-term outcome of CT-guided radiofrequency ablation (RFA) of spinal osteoid osteomas (OO) and osteoblastomas (OB) in six different European centres.

Methods

Eighty-seven patients with spinal OO (77) or OB (10) were treated with CT-guided RFA, after three-dimensional CT-guided access planning. Patient’s long-term outcome was assessed by clinical examination and questionnaire-based evaluation including 10-point visual analogue scales (VAS) regarding the effect of RFA on severity of pain and limitations of daily activities. Clinical success was defined as a reduction of > 30% in the VAS score and patient’s satisfaction.

Results

Overall, RFA was technically successful in 82/87 cases (94.3%) with no major complications; clinical success was achieved in 78/87 cases (89.7%). The OO/OB were localized in the cervical (n = 9/3), the thoracic (n = 27/1), the lumbar (n = 29/4), and the sacral spine (n = 12/2). A decrease in severity of pain after RFA was observed in 86/87 patients (98.9%) with a persistent mean reduction of overall pain score from 8.04 ± 0.96 to 1.46 ± 1.95 (p < 0.001) after a median follow-up time of 29.35 ± 35.59 months. VAS scores significantly decreased for limitations of both daily (5.70 ± 2.73 to 0.67 ± 1.61, p < 0.001) and sports activities (6.40 ± 2.58 to 0.67 ± 1.61, p < 0.001).

Conclusion

In a multicentric setting, this trial proves RFA to be a safe and efficient method to treat spinal OO/OB and should be regarded as first-line therapy after interdisciplinary case discussion.

Keywords

Osteoid osteoma Osteoblastoma Spine Radiofrequency ablation CT-guided intervention European multicentre study 

Notes

Funding

This study received no funding.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Gangi A, Alizadeh H, Wong L, Buy X, Dietemann JL, Roy C (2007) Osteoid osteoma: percutaneous laser ablation and follow-up in 114 patients. Radiology 242(1):293–301CrossRefGoogle Scholar
  2. 2.
    Motamedi D, Learch TJ, Ishimitsu DN, Motamedi K, Katz MD, Brien EW, Menendez L (2009) Thermal ablation of osteoid osteoma: overview and step-by-step guide. Radiographics 29(7):2127–2141CrossRefGoogle Scholar
  3. 3.
    De Filippo M, Russo U, Papapietro VR, Ceccarelli F, Pogliacomi F, Vaienti E, Miele V (2018) Radiofrequency ablation of osteoid osteoma. Acta Biomed 89(1-S):175–185Google Scholar
  4. 4.
    Pourfeizi HH, Tabrizi A, Bazavar M, Sales JG (2014) Clinical findings and results of surgical resection of thoracolumbar osteoid osteoma. Asian Spine J 8(2):150–155CrossRefGoogle Scholar
  5. 5.
    Lucas DR (2010) Osteoblastoma. Arch Pathol Lab Med 134(10):1460–1466Google Scholar
  6. 6.
    Orguc S, Arkun R (2014) Primary tumors of the spine. Semin Musculoskelet Radiol 18(3):280–299CrossRefGoogle Scholar
  7. 7.
    Papaioannou G, Sebire NJ, McHugh K (2009) Imaging of the unusual pediatric ‘blastomas’. Cancer Imaging 9:1–11CrossRefGoogle Scholar
  8. 8.
    Mungo DV, Zhang X, O’Keefe RJ, Rosier RN, Puzas JE, Schwarz EM (2002) COX-1 and COX-2 expression in osteoid osteomas. J Orthop Res 20(1):159–162CrossRefGoogle Scholar
  9. 9.
    Boriani S, Amendola L, Bandiera S, Simoes CE, Alberghini M, Di Fiore M, Gasbarrini A (2012) Staging and treatment of osteoblastoma in the mobile spine: a review of 51 cases. Eur Spine J 21(10):2003–2010CrossRefGoogle Scholar
  10. 10.
    Gasbarrini A, Cappuccio M, Bandiera S, Amendola L, van Urk P, Boriani S (2011) Osteoid osteoma of the mobile spine: surgical outcomes in 81 patients. Spine (Phila Pa 1976) 36(24):2089–2093CrossRefGoogle Scholar
  11. 11.
    Li Z, Zhao Y, Hou S, Mao N, Yu S, Hou T (2013) Clinical features and surgical management of spinal osteoblastoma: a retrospective study in 18 cases. PLoS One 8(9):e74635CrossRefGoogle Scholar
  12. 12.
    Omlor GW, Lehner B, Wiedenhöfer B, Deininger C, Weber MA, Rehnitz C (2012) [Radiofrequency ablation in spinal osteoid osteoma. Options and limits]. Orthopade 41(8):618–622CrossRefGoogle Scholar
  13. 13.
    Zileli M, Cagli S, Basdemir G, Ersahin Y (2003) Osteoid osteomas and osteoblastomas of the spine. Neurosurg Focus 15(5):E5Google Scholar
  14. 14.
    Rehnitz C, Sprengel SD, Lehner B, Ludwig K, Omlor G, Merle C, Weber MA (2012) CT-guided radiofrequency ablation of osteoid osteoma and osteoblastoma: clinical success and long-term follow up in 77 patients. Eur J Radiol 81(11):3426–3434CrossRefGoogle Scholar
  15. 15.
    Rehnitz C, Sprengel SD, Lehner B, Ludwig K, Omlor G, Merle C, Weber MA (2013) CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features. Diagn Interv Radiol 19(4):330–339Google Scholar
  16. 16.
    Rimondi E, Mavrogenis AF, Rossi G, Ciminari R, Malaguti C, Tranfaglia C, Vanel D, Ruggieri P (2012) Radiofrequency ablation for non-spinal osteoid osteomas in 557 patients. Eur Radiol 22(1):181–188CrossRefGoogle Scholar
  17. 17.
    Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ (2003) Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 229(1):171–175CrossRefGoogle Scholar
  18. 18.
    Schmidt D, Clasen S, Schaefer JF, Rempp H, Duda S, Trübenbach J, Pereira PL (2011) [CT-guided radiofrequency (RF) ablation of osteoid osteoma: clinical long-term results]. Rofo 183(4):381–387CrossRefGoogle Scholar
  19. 19.
    Rybak LD, Gangi A, Buy X, La Rocca Vieira R, Wittig J (2010) Thermal ablation of spinal osteoid osteomas close to neural elements: technical considerations. AJR Am J Roentgenol 195(4):W293–W298CrossRefGoogle Scholar
  20. 20.
    Trotta B, Fox MG (2013) Benign osteoid-producing bone lesions: update on imaging and treatment. Semin Musculoskelet Radiol 17(2):116–122CrossRefGoogle Scholar
  21. 21.
    Vanderschueren GM, Obermann WR, Dijkstra SP, Taminiau AH, Bloem JL, van Erkel AR (2009) Radiofrequency ablation of spinal osteoid osteoma: clinical outcome. Spine (Phila Pa 1976) 34(9):901–904CrossRefGoogle Scholar
  22. 22.
    Weber MA, Sprengel SD, Omlor GW, Lehner B, Wiedenhöfer B, Kauczor HU, Rehnitz C (2015) 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. Skelet Radiol 44(7):981–993CrossRefGoogle Scholar
  23. 23.
    Pinto CH, Taminiau AH, Vanderschueren GM, Hogendoorn PC, Bloem JL, Obermann WR (2002) Technical considerations in CT-guided radiofrequency thermal ablation of osteoid osteoma: tricks of the trade. AJR Am J Roentgenol 179(6):1633–1642CrossRefGoogle Scholar
  24. 24.
    Albisinni U, Rimondi E, Malaguti MC, Ciminari R (2004) Radiofrequency thermoablation in the treatment of osteoid osteoma. Radiology 232(1):304; author reply 304-5–305CrossRefGoogle Scholar
  25. 25.
    Jankharia B, Burute N (2009) Percutaneous radiofrequency ablation for osteoid osteoma: how we do it. Indian J Radiol Imaging 19(1):36–42CrossRefGoogle Scholar
  26. 26.
    Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 33(1):90–94CrossRefGoogle Scholar
  27. 27.
    Albisinni U, Facchini G, Spinnato P, Gasbarrini A, Bazzocchi A (2017) Spinal osteoid osteoma: efficacy and safety of radiofrequency ablation. Skelet Radiol 46(8):1087–1094CrossRefGoogle Scholar
  28. 28.
    Bitsch RG, Rupp R, Bernd L, Ludwig K (2006) Osteoid osteoma in an ex vivo animal model: temperature changes in surrounding soft tissue during CT-guided radiofrequency ablation. Radiology 238(1):107–112CrossRefGoogle Scholar
  29. 29.
    Dupuy DE, Hong R, Oliver B, Goldberg SN (2000) Radiofrequency ablation of spinal tumors: temperature distribution in the spinal canal. AJR Am J Roentgenol 175(5):1263–1266CrossRefGoogle Scholar
  30. 30.
    Faddoul J, Faddoul Y, Kobaiter-Maarrawi S, Moussa R, Rizk T, Nohra G, Maarrawi J (2017) Radiofrequency ablation of spinal osteoid osteoma: a prospective study. J Neurosurg Spine 26(3):313–318CrossRefGoogle Scholar
  31. 31.
    Klass D, Marshall T, Toms A (2009) CT-guided radiofrequency ablation of spinal osteoid osteomas with concomitant perineural and epidural irrigation for neuroprotection. Eur Radiol 19(9):2238–2243CrossRefGoogle Scholar
  32. 32.
    Rimondi E, Bianchi G, Malaguti MC, Ciminari R, Del Baldo A, Mercuri M, Albisinni U (2005) Radiofrequency thermoablation of primary non-spinal osteoid osteoma: optimization of the procedure. Eur Radiol 15(7):1393–1399CrossRefGoogle Scholar
  33. 33.
    Vanderschueren GM, Taminiau AH, Obermann WR, Bloem JL (2002) Osteoid osteoma: clinical results with thermocoagulation. Radiology 224(1):82–86CrossRefGoogle Scholar
  34. 34.
    Wang B, Han SB, Jiang L, Yuan HS, Liu C, Zhu B, Liu ZJ, Liu XG (2017) Percutaneous radiofrequency ablation for spinal osteoid osteoma and osteoblastoma. Eur Spine J 26(7):1884–1892CrossRefGoogle Scholar
  35. 35.
    Martel J, Bueno A, Nieto-Morales ML, Ortiz EJ (2009) Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation. Eur J Radiol 71(3):564–569CrossRefGoogle Scholar
  36. 36.
    Vidoni A, Grainger M, James S (2018) Experience of neuroprotective air injection during radiofrequency ablation (RFA) of spinal osteoid osteoma. Eur Radiol 28(10):4146–4150CrossRefGoogle Scholar
  37. 37.
    Laus M, Albisinni U, Alfonso C, Zappoli FA (2007) Osteoid osteoma of the cervical spine: surgical treatment or percutaneous radiofrequency coagulation. Eur Spine J 16(12):2078–2082CrossRefGoogle Scholar
  38. 38.
    Oliveira CR, Mendonça BB, Camargo OP, Pinto EM, Nascimento SA, Latorre MR, Zerbini MC (2007) Classical osteoblastoma, atypical osteoblastoma, and osteosarcoma: a comparative study based on clinical, histological, and biological parameters. Clinics (Sao Paulo) 62(2):167–174CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Thomas Beyer
    • 1
    Email author
  • Carla S. P. van Rijswijk
    • 2
  • Jose Martel Villagrán
    • 3
  • Christoph Rehnitz
    • 4
  • Mario Muto
    • 5
  • Christian von Falck
    • 6
  • Jan Gielen
    • 7
  • Kolja M. Thierfelder
    • 1
  • Marc-André Weber
    • 1
    • 4
  1. 1.Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and NeuroradiologyUniversity Medical Centre RostockRostockGermany
  2. 2.Department of RadiologyLeiden University Medical CentreLeidenThe Netherlands
  3. 3.Diagnóstico por ImagenHospital Universitario Fundación AlcorcónAlcorcónSpain
  4. 4.Department of Diagnostic and Interventional RadiologyHeidelberg University HospitalHeidelbergGermany
  5. 5.Neuroradiology DepartmentCardarelli HospitalNaplesItaly
  6. 6.Department of Diagnostic and Interventional RadiologyHannover Medical SchoolHannoverGermany
  7. 7.Department of RadiologyAntwerp University HospitalAntwerpBelgium

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