Percutaneous ct-guided excision of osteoid osteoma

Introduction: Osteoid osteoma is a benign bone tumor. Nidus which its diameter is narrower than 20 mm is responsible for the pathogenesis of the illness. Current treatment approach is surgical treatment. In surgical treatment, nidus excision is aimed. For this aim, many opened and closed methods have been developed. Percutaneous excision method which provides more success and less bone loss has been more popular recently. Purpose: It evaluates the clinical and radiological results of osteoid osteoma facts which accompanied with computerized tomography (CT) by notation and trephine en-block wide resection. Patients and Method: Between 2012-2014 years, 24 patients with Osteoidosteoma diagnosis whom percutaneous nidus excision were applied accompanied with CT were evaluated retrospectively. 18 (%75) of the patient were male and 6 (%25) of them were female. Average age was 15.3 (between 4-27) and average length of follow-up was 18.2 (between 11-25) months. Notation was done accompanied with CT by K-wire. Then, in sterilized environment, en-block wide resection was applied by notation string. After resection cut walls were curettaged. Treatment efficiency was evaluated by preop-postop VAS (Visual Analog Acale) and FPS (Face Pain Scale) pain stocking. Cortical defect follow-up was done by X-ray. Results: in 21 percent of patients successful results and in 3 percent patients unsuccessful results were obtained. According to VAS scale, average preoperative pain level was determined 7,8 and average postoperative pain level was determined 0,75. The widest diameter of nidus was measured 11 mm. Average notation time was 14 minutes; average operation time was 44, 3 minutes. Average time of keeping in hospital determined as 1.17 day (between 1-2). 83 percent of the cases were verified histologically. In one patient, pathological fracture occurred three months after operation. In two patients infection occurred. Intraoperative fracture and neurovascular injury did not occur. Conclusion: In Osteoid osteoma treatment, Percutaneous excision by trephine accompanied with CT is an economical, practical treatment which have high success rate, low complication rate, low cost. Key Words: Osteoid osteoma, Percutaneous Excision, Benign Bone Tumor