Osteoid osteoma is a benign osteoblastic (bone producing) tumor. The literature suggests that its natural history is a history of resolving pain and healing of the lesions, but the course can be variable. The course of this disease is unpredictable and protracted, with intervals of resolution of pain that sometimes last 6-15 years. Initial treatment of osteoid osteoma remains nonoperative, with medications such as aspirin on other non-steroidal pain and inflammation relievers.
Percutaneous radiofrequency coagulation or ablation of the nidus the osteoma is performed by using an electrode placed in the lesion, coupled with a radiofrequency generator that produces local tissue destruction by converting radiofrequency into heat. Complete or nearly complete relief of pain often occurs within 3 days. Patients are sent home on same day of surgery, and they have no limitations in weight bearing, though aggressive athletics are restricted for 2-3 months. Patients may then return to normal activities immediately or within 24-48 hours after surgery. For this reason, it is currently the favored procedure for osteoblastic osteoma. It works fast; Pain resolves quickly, and limping resolves within 24 hours. Furthermore, this procedure requires only a small osseous access to allow insertion of the electrode; therefore, no substantial structural weakening of the bone occurs. Primary cure rates are 83-94%. Cure with a second ablation procedure is approximately 100% and recurrence is very rare.
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