1 / 27

CT guided RadioFrequency Ablation in 24 patients with spinal osteoid osteomas

CT guided RadioFrequency Ablation in 24 patients with spinal osteoid osteomas. J.A.M Bramer, dep. Orthopedic surgery P.D.S. Dijkstra, dep. orthopedic surgery W.R.Obermann , dep. radiology A.H.M. Taminiau, dep. orthopedic surgery. Osteoid Osteoma in the spine. Benign Nidus

mandel
Download Presentation

CT guided RadioFrequency Ablation in 24 patients with spinal osteoid osteomas

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CT guided RadioFrequency Ablation in 24 patients with spinal osteoid osteomas J.A.M Bramer, dep. Orthopedic surgery P.D.S. Dijkstra, dep. orthopedic surgery W.R.Obermann, dep. radiology A.H.M. Taminiau, dep. orthopedic surgery

  2. Osteoid Osteoma in the spine • Benign • Nidus • < 20 mm • 10% in spine • Pain • Scoliosis CTOS 2005

  3. Open surgery • Difficult localization • Incomplete excision • High recurrence rate • High complication rate Ozaki, CLINICAL ORTHOP. REL. RES. 2002 Number 397, 394–402 CTOS 2005

  4. Radio Frequency Ablation • RF ablation under CT guidance • Bonopty drilling system • Radi Medical Systems, Uppsala, Sweden • RF ablation probe • Radionics-RFG3C RF-lesion Generator System, Burlington, USA CTOS 2005

  5. RadioFrequency Ablation de Berg, JC Lancet 1995; 350-1. CTOS 2005

  6. Procedure Materials CTOS 2005 RF needle RF needle biopsy biopsy drills drills cannula + stylet cannula + stylet

  7. Procedure General Anesthetics CTOS 2005

  8. Procedure Positioning of probe CTOS 2005

  9. S3 CTOS 2005

  10. Radio Frequency Ablation CTOS 2005

  11. Study • Period 1995-2005 • Patients 24 • Follow up 54 months (6-120) CTOS 2005

  12. Material and Methods • Gender 16 ♂, 8 ♀ • Median age 23 years (8 – 55) • Median size lesion 8.5 mm (5 - 15) • Volume 0,7 cm3 (0,1-2,5) CTOS 2005

  13. Location 24 locations in 24 patients • Cervical 3 • Thoracic 10 • Lumbar 7 • Sacral 4 CTOS 2005

  14. Distance lesion to vital structures ≤ 2mm in 15 patients : • Dural sac 12 • Foramen 10 • Vertebral artery 1 • Nerve root 1 Hadjipavlou AGSpine. 2003 28(22):E472-7 CTOS 2005

  15. Material and Methods • Biopsy in all patients • No material 7 • Insufficient material 4 • Confirming 13 CTOS 2005

  16. Location in vertebrae • Posterior • Pedicle 8 • Arch 7 • Pars interarticularis 4 • Transverse process 2 • Anterior • Vertebral body 3 CTOS 2005

  17. Procedures CTOS 2005

  18. Results • Residual disease in 5 patients: • Second procedure 3 (3, 9 and 10 months) • Third procedure 1 (28 months) • Open surgery 1 (6 months) CTOS 2005

  19. Results • DISEASE FREE AT FINAL FU 100% NO PAIN CTOS 2005

  20. Results • Scoliosis • Before procedure 58% (14) • After procedure 17% (4) CTOS 2005

  21. Results • Complications NONE • Skin Burns 0 • Neurological deficit 0 Sans N, Radiology 1999;212: 687–92. CTOS 2005

  22. C3 mid lesion CTOS 2005

  23. C3 MRI T1 CTOS 2005

  24. 2nd RF Ablation C3 3 months CTOS 2005

  25. 2nd RF Ablation C3 8 months CTOS 2005

  26. Conclusion • CT-guided RF ablation of spinal osteoid osteomas is a successful minimal invasive procedure • It is safe if the thermo probe is positioned at least 5 mm from vital structures • Open surgery in case of tumor adherent to nerve root CTOS 2005

  27. The combination of percutaneous radiofrequency heat ablation and vertebroplasty seems to be a promising, feasible, minimally invasive technique in the treatment of spinal metastases with cortical defects bedankt

More Related