• Xiang Yu, Ben Wang, ShaoMin Yang, SongBo Han, Liang Jiang, XiaoGuang Liu, Feng Wei, FengLiang Wu, Lei Dang, and ZhongJun Liu.
• Department of Orthopaedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China; Peking University Health Science Center, No. 38 XueYuan Road, Haidian District, Beijing 100191, China.
• Spine J. 2019 Mar 1; 19 (3): 509-515.

Background ContextBoth open surgical resection (OSR) and radiofrequency ablation (RFA) have been reported for spinal osteoid osteoma (OO).PurposeTo verify the clinical safety and efficiency of RFA with OSR in treating spinal OO.Study DesignRetrospective cohort study.Patient SampleTwenty-eight consecutive patients with spinal OO who underwent either RFA or OSR in our institute between September 2006 and December 2016.Outcome MeasuresThe age, gender, lesion distribution, surgical time, estimated blood loss, complications, local recurrence, visual analogue scale (VAS), and the modified Frankel grade were documented.MethodsWe retrospectively reviewed 28 patients with spinal OO who had been treated in our hospital from September 2006 to December 2016. Patients were followed at 3, 6, 12, and 24 months after the index surgery. The minimum follow-up period was 12 months. This study was funded by Peking University Third Hospital (Y71508-01) (¥ 400,000).ResultsTwelve and 16 patients were treated with CT-guided percutaneous RFA and OSR, respectively. Spinal OO locations were cervical in 4, thoracic in 4, lumbar in 3, and sacral vertebra in 1 in the RFA group and cervical in 12, thoracic in 1, and lumber in 3 in the OSR group. RFA showed shorter operating time, less blood loss, and less in-hospital stay than open surgery [105.0 ± 33.8 minutes vs. 186.4 ± 53.5 minutes (p < .001), 1 (0 to 5) ml vs. 125 (30-1200) ml (p < .001) and 1 (1-3) days vs. 6 (3-10) days (p < .001), respectively]. At last follow-up, one patient underwent a secondary RFA for recurrence. VAS improvement was 7.5 (3-10) and 6.5 (4-9) (p = .945) in the RFA and OSR groups, respectively. The overall complication rate was 8.3% (1/12) and 18.8% (3/16) in the RFA and OSR groups, respectively.ConclusionsIf there is sufficient cerebrospinal fluid between the spinal OO lesion and spinal cord/nerve root (more than 1 mm), RFA is effective and safe for treatment of well-selected spinal OO, showing reduced operating time, blood loss, in-hospital stay, and complications compared to OSR. However, OSR is still recommended in cases with spinal cord/nerve root compression.Copyright © 2018 Elsevier Inc. All rights reserved.

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