Once an osteoid osteoma causes discomfort such as severe, boring pain, it must be resected (surgically removed).The challenge in the surgical procedure is hitting the nidus in the severe bone sclerosis. The nidus must be completely removed. It is responsible for the pain. The bone sclerosis is left behind.
Damage to muscles, tendons, soft tissues and also nerves located in the surgical access path to the nidus cannot always be excluded.
Caveat: Curettage (excision) is not recommended because it is often associated with recurrence (recurrence of the disease).
CT-guided radiofrequency ablation (RFA)
CT-guided radiofrequency ablation (RFA) (synonyms: thermal ablation; sclerotherapy) of the nidus is now considered standard therapy. In this procedure, a special probe is inserted into the nidus and heated via an alternating current field at the tip. This destroys the prostaglandin-producing cells (prostaglandin = tissue hormone that triggers pain, among other things) in the center and the pain conduction pathways. The procedure is minimally invasive.Another option of heat ablation is laser ablation (LA).
About 90% of patients are expected to be permanently pain-free after heat ablation.
10% of patients suffer from residual pain or the pain recurs over time. In that case, thermal ablation is repeated.
