Non–Operating Room Anesthesia in Osteoid Osteoma Ablative Treatment

Purpose: To verify the effectiveness and complication rate during radiofrequency ablation (RFA) in the treatment of osteoid osteoma (OO) with the non–operating room anesthesia (NORA) protocol.

Methods and Materials: From 2016 to 2019, 61 patients affected by OO (40 men and 21 women) with an average age of 20.7 years underwent computed tomography (CT)-guided percutaneous radiofrequency ablation (RFA) with NORA. Lesion sites treated were femur (27), tibia (22), pelvis (2), talar bone (3), distal radius (1), and humerus (6). Mean follow-up time was 36 months. In each case, anesthesiological support followed NORA, a new protocol approved by our institution. Primary success rate, complications, symptom-free intervals, and follow-up results were evaluated.

Results: Pain relief (evaluated with the visual analog scale) was significant in 97% of patients; it disappeared within 24 hours of the procedure in 44 patients, within 3 days in 10 patients, and within 7 days in 7 patients. After 6 months of observation time, 60 of 61 patients were treated successfully and had no further complaints. In two patients, two major complications occurred: infection of the site treated, healed with antibiotics, and a nerve lesion, healed with steroid therapy. No other complications were observed.

Conclusion: RFA is a highly effective, efficient, minimally invasive, and safe method for the treatment of OO following the NORA protocol.

Fig. 1 Computed tomography–guided percutaneous radiofrequency ablation with the non–operating room anesthesia protocol.

Fig. 2 Osteoid osteoma.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
17 December 2020