Radiofrequency Ablation of Osteoid Osteoma with Use of Intraoperative Three-Dimensional Imaging and Surgical Navigation.

Abstract

During the performance of radiofrequency ablation of osteoid osteomas, the use of intraoperative cone-beam computed tomography (CT) imaging with surgical navigation lowers radiation exposure while allowing real-time targeting of the nidus. Review all images to confirm a high level of confidence in the radiographic diagnosis. Be sure to position and set up properly. Attach the optical array to the target bone. Set up the intraoperative CT (O-Arm) machine and acquire the initial images for surgical navigation. Analyze the initial images, rotated or positioned as necessary, to allow you to proceed with the planned direction and angle of approach to the nidus. Register the surgical instruments with the surgical navigation unit. Target the nidus and then insert the Kirschner wire into its center. Once the accuracy of the Kirschner wire placement is confirmed, exchange it for the radiofrequency probe and perform a CT scan to confirm proper probe placement. Perform a CT scan to confirm proper placement of the probe within the center of the nidus. Perform the radiofrequency treatment to ablate the cells within the nidus. We conducted a study of three different techniques of radiofrequency ablation.IndicationsContraindicationsPitfalls & Challenges.