Percutaneous Image-guided Laser Photocoagulation of Spinal Osteoid Osteoma: A Single-Institution Series.

Details

Serval ID
serval:BIB_393469526247
Type
Article: article from journal or magazin.
Collection
Publications
Title
Percutaneous Image-guided Laser Photocoagulation of Spinal Osteoid Osteoma: A Single-Institution Series.
Journal
Radiology
Author(s)
Tsoumakidou G., Thénint M.A., Garnon J., Buy X., Steib J.P., Gangi A.
ISSN
1527-1315 (Electronic)
ISSN-L
0033-8419
Publication state
Published
Issued date
03/2016
Peer-reviewed
Oui
Volume
278
Number
3
Pages
936-943
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To retrospectively evaluate the safety and efficacy of percutaneous image-guided laser photocoagulation for the treatment of spinal osteoid osteoma (OO) in proximity to neural structures.
This study was institutional review board-approved with waivers of informed consent. From January 1994 until October 2014, 58 patients with spinal OO (mean age, 25 years; 40 men, 17 women) were treated in one institution by using laser photocoagulation with combined computed tomographic (CT) and fluoroscopic guidance. One patient was excluded because of less than 3 months of follow-up. All patients had typical clinical and imaging findings. Clinical features, radiologic data, and procedure-related data were reviewed, and limitations, complications, and failure rate were evaluated. All data were expressed as means ± standard deviation. P values of less than .05 were indicative of statistical significance.
OO was in the vertebral body for 18 of 57 patients, the neural arch for 21 of 57 patients, and the articular process for 18 of 57 patients. Mean nidal diameter was 8 mm, and the mean distance from the closest neural structure was 6.6 mm (minimum distance, ≤5 mm in 35 of 57 patients). In 35 of 57 patients, no cortical coverage was present between the nidus and neural structure in danger. Mean total energy delivered was 1271 J (2-watt continuous power mode). Thermal insulation (carbon dioxide and/or hydrodissection), temperature monitoring, and electrostimulation were used in 42, 24, and one patient, respectively. Primary clinical success at 1 month was 98.2%. Total recurrence rate was 5.3%. All recurrences were addressed percutaneously. Secondary success rate was 100%. One-year follow-up is available in 54 of 57 patients. No major complications were noted.
Spinal OO can be safely and effectively treated with percutaneous laser photocoagulation. In cases that are less than 8 mm to 10 mm distance and in the absence of cortical coverage, thermal protection techniques of the neural structures should be used.
Keywords
Adolescent, Adult, Child, Child, Preschool, Female, Humans, Lasers, Light Coagulation/instrumentation, Male, Middle Aged, Osteoma, Osteoid/diagnostic imaging, Osteoma, Osteoid/surgery, Retrospective Studies, Spinal Neoplasms/diagnostic imaging, Spinal Neoplasms/surgery, Tomography, X-Ray Computed, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
09/10/2018 11:26
Last modification date
20/08/2019 13:28
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