Surgery Versus Radiofrequency Ablation in the Management of Spinal Osteoid Osteomas: A Spine Oncology Referral Center Comparison Analysis of 138 Cases

BACKGROUND: Osteoid osteomas (OOs) are benign bone forming tumors that, usually, occur in the extremities, with about 10% of them arising in the spine more commonly in the posterior elements. The aim of this study is to evaluate the long-term results of patients suffering from spinal 00 treated with surgery and radiofrequency ablation. METHODS: This was a retrospective comparison analysis or data prospectively collected from 2 cohorts of consecutive patients diagnosed with 00 of the spine treated at the same Institute from November 2002 to February 2019. The first cohort included patients submitted to an intralesional extracapsular excision of the lesion (surgery group); the second cohort included patients submitted to radiofrequency ablation (RFA group). RESULTS: The surgery group showed a local recurrence rate of 1.7% versus a recurrence rate of 12.5% in the RFA group with a statistically significant difference in the disease-free survival at longest follow-up (P = 0.012). No statistically significant differences were observed in local recurrence rate stratified for level and site of lesion. No complications were observed in both groups at the time of first procedure. CONCLUSIONS: Surgery and RFA are both safe and effective interventional procedures for the management of spinal 00, although RFA is associated with a greater recurrence rate. Treatment should be tailored according to the relationship of lesions with neural structures and to advantages and disadvantages of each technique.

Automated summary

Surgery and radiofrequency ablation are both safe and effective interventions for spinal osteoid osteoma, with the latter associated with a higher recurrence rate. Treatment choice should consider lesion location in relation to neural structures and the pros and cons of each technique.