Laser photocoagulation for osteoid osteoma treatment

The purpose of the study was to evaluate interstitial laser photocoagulatio n for local destruction of osteoid osteoma, with computed tomographic (CT) guidance. Material and methods 28 patients (age range from 5 to 48 years) with presumed osteoid osteoma we re treated with CT-guided interstitial laser photocoagulation of the nidus. A high power semiconductor diode laser (805 nm) with a 400 mu m optical fi ber was used. The fiber was introduced into the nidus through a 18-gauge ne edle. Around the fiber tip, well-defined coagulative necroses from 5 to 9 m m (energy delivery, 400-1000J) were obtained. Results 27 patients had complete pain relief, which was effective within 24 hours i n 18 patients. One patient had pain recurrence after 6 weeks. The remaining nidus was treated secondarly with complete relief. Treatment was unsuccess ful in one patient, and surgical excision was performed. All patients were followed up for more than 1 year, with no sign of recurrence. The only nota ble complication was a mild reflex sympathetic dystrophy of the wrist in on e patient. Sclerosis of the nidus was observed 6-12 months after the proced ure. Conclusion Percutaneous interstitial laser photocoagulation of osteoid osteoma seems t o be a promising, simple, precise, and minimally invasive alternative to tr aditional surgical and percutaneous ablations.