OSTEOID OSTEOMA - PERCUTANEOUS RESECTION WITH CT GUIDANCE

In 24 patients with presumed osteoid osteoma in the appendicular skele ton (n = 23) and lumbar spine (n = 1), percutaneous resection with a d rill system and computed tomographic (CT) guidance was performed. In t he procedure, a 7-mm-diameter toothed drill inserted over a guide wire is used to remove the nidus. Twenty-three patients were successfully treated. Histologic confirmation of osteoid osteoma was obtained in 19 cases. In one patient, open surgery with bone grafting and osteosynth esis was necessary because of inadvertent extensive bone resection res ulting from damage to the drill. All patients have remained free of pa in and recurrence for 3-24 months. Although the procedure was effectiv e in all patients, the 7-mm diameter of the toothed drill may cause di fficulty in small bones or even danger in areas such as the posterior vertebral arch. In locations such as the tubular bones of the lower ex tremity and the femoral neck, however, this technique is feasible and may become the treatment of choice for osteoid osteoma.