Osteoid osteoma: treatment outcome and long-term follow-up after MRI-guided laser ablation

BACKGROUND: Aim of this study was to investigate short-term and long-term treatment outcome, complication rates, and patient satisfaction after MRI-guided laser ablation (LA) of osteoid osteoma (OO). METHODS: Thirty-five patients with OO in typical and atypical localizations were treated by MRI-guided LA with MRI thermometry in an open 1.0 T system. Twenty-nine patients underwent a standardized telephone interview including questions about recurrence, residual pain or functional symptoms, and satisfaction for short-term follow-up after a mean of 31 months. Twenty-one of these patients were available for long-term telephone follow-up after a mean of 116 months. RESULTS: Technical success of MRI-guided LA was 100% without major complications. Two minor complications included transient local inflammation and transient damage of the peroneal nerve associated with improper patient positioning during the procedure. Primary clinical success was 92% (11/12) in typically located OO and 82% (14/17) in atypically located OO. Secondary clinical success after repeat ablation was 100% regardless of OO location. Patient satisfaction and acceptance of the intervention were very good at both short-term (97%) and long-term (100%) follow-up. CONCLUSIONS: MRI-guided LA of OO is a safe and effective treatment option resulting in high short-term and long-term patient satisfaction and acceptance rates. Recurrence and adverse events were more common in patients with atypically located OO. Level of Evidence: Level 3, non-randomized follow-up study.