THE EFFICACY OF CT-GUIDED PRECISE RESECTION IN THE TREATMENT OF OSTEOID OSTEOMA

Abstract

Purpose: The purpose of this study was to assess the clinical efficacy of intraoperatively CT-guided minimally invasive open surgery in the treatment of osteoid osteoma (OO). Methods: Medical records and imaging data were reviewed for all patients diagnosed with OO from January 2014 to December 2018 at our institution. During this period, fourteen patients treated by intraoperative CT-guided mini-open resection were included. Under general anesthesia and with the assistance of intraoperative CT, we removed the tumor nidus and surrounding dense sclerotic bone with mini-open excision. The demographics, clinical and radiographic data of fourteen patients were retrospectively analyzed. The operation time, blood loss, incision length, visual analogue scale (VAS), and other indicators were recorded to evaluate the clinical safety and efficacy of the operation. Clinical success was defined by the absence of OO related pain after surgery, and technical success was confirmed by pathological examination. Results: Fourteen patients including 12 males and 2 females were enrolled, with an average age of 21. Complete excision was achieved in all 14 patients, which was confirmed by postoperative pathological examination. The mean follow-up time was 37.9 ± 13.9 months (range, 22 to 63 months). The mean operation time, blood loss and incision length were 27.8 ± 14.2 minutes (range, 11 to 55 minutes), 31.1 ± 21.8 ml (range, 5 to 80 ml) and 3.6 ± 1.5 cm (range, 2 to 6 cm), respectively. For all 14 patients, the characteristic pain was relieved to different extent, with postoperative VAS score decreasing compared with that before surgery. The mean VAS score of 1 month and 1 year after surgery was 0.4 (range, 1 to 2) and 0, respectively. There was no complication related to intraoperative CT navigation. Moreover, no recurrence and serious complications were observed during the mean follow-up period of 37.9 ± 13.9 months (range, 22 to 63 months). Conclusion: Open surgery guided by intraoperative CT is a safe and reliable treatment for patients with osteoid osteoma in the lower extremity, which can be an alternative for surgeons.