2Department of Orthopedics and Traumatology, Yozgat City Hospital, Yozgat, Türkiye
3Department of Orthopedics and Traumatology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
4Department of Orthopedics and Traumatology, Dicle University, Faculty of Medicine, Diyarbakır, Türkiye
5Department of Radiology, Dicle University, Faculty of Medicine, Diyarbakır, Türkiye
6Department of Orthopedics and Traumatology, Istanbul Medicana Hospital, Istanbul, Türkiye
Abstract
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.