Objective: Osteoid osteoma (OO) is a common benign bone tumor typically affecting individuals under 25, characterized by localized pain responsive to non-steroidal anti-inflammatory drugs. Complete nidus removal is the primary treatment goal. While computed tomography (CT)-guided percutaneous excision is popular, trephine excision offers a cost-effective alternative, allowing histopathological confirmation. This study aimed to evaluate the clinical and radiological outcomes of CT-guided percutaneous nidus excision using a trephine.
Materials and
Methods: This retrospective study included 24 patients (18 males and 6 females; mean age 15.3 years) diagnosed with OO who underwent CT-guided percutaneous nidus excision using standard orthopedic trephines. Pain severity (Visual Analog Scale [VAS]/faces pain scale), operation time, hospital stay, technical success (complete nidus removal), clinical success (pain resolution without recurrence), and complications were recorded. A paired t-test compared pre- and post-operative pain scores (significance at p<0.05).

Results: The mean pre-operative VAS score significantly decreased from 7.72±1.97 to 0.79±1.84 postoperatively (p<0.001). Technical success was achieved in 23/24 patients (96%). Clinical success was observed in 21/24 patients (87.5%), with three recurrences potentially linked to marking errors or larger nidus sizes. No intraoperative neurovascular injuries or fractures occurred. Post-operative complications included two deep infections and one delayed fracture. Histopathological confirmation of OO was obtained in 20/24 cases (83%).

Conclusion: CT-guided percutaneous trephine excision is an effective and safe treatment modality for OO, demonstrating high technical and clinical success rates with a low incidence of major complications and allowing for histopathological diagnosis. Further prospective studies with larger cohorts are warranted.