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Cardiovascular and Interventional... May 2021To evaluate safety and efficacy of percutaneous ablative therapy for the treatment for osteoid osteomas. (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate safety and efficacy of percutaneous ablative therapy for the treatment for osteoid osteomas.
MATERIALS AND METHODS
PubMed database, Web of Science, and SCOPUS were searched from their inception until November 2019 for articles describing osteoid osteoma. Demographic data, success rates, pre- and post-procedure VAS scores, and complications were recorded. A random-effects meta-analyses of the VAS pain score at various time points were calculated.
RESULTS
For radiofrequency ablation, VAS scores for pain at pre-procedure, 24-48 h, and 3-6 months yielded cumulative pain scores of 7.64 +/- 0.175, 0.78 +/- 0.186, and 0.02 +/- 0.0196, respectively. For cryoablation, VAS scores at pre-procedure, 24-48 h, and 3-6 months yielded cumulative pain scores of 8.46 +/- 0.549, 0.975 +/- 0.66, and 0.112 +/- 0.08, respectively. For laser ablation, VAS scores at pre-procedure and 24-48 h yielded cumulative pain scores of 4.94 +/- 1.42, and 0.506 +/- 0.268, respectively. For microwave ablation, VAS scores at pre-procedure, 24-48 h, and 3-6 months yielded cumulative pain scores of 6.14 +/- 1.07, 1.636 +/- 1.215, and 0 +/- 0.0, respectively. All ablation methods resulted in significant immediate and lasting pain reduction (p < 0.001). Technical and clinical success rates and major complications for RFA, microwave ablation, laser ablation, and cryoablation did not differ significantly. Overall recurrence of bone pain at the same site occurred in 4.06% of all patients an average of 11 months post-procedure.
CONCLUSION
Percutaneous ablative therapies are safe and result in significant and lasting pain reduction as demonstrated through visual analog scale pain scores.
Topics: Ablation Techniques; Bone Neoplasms; Disease Management; Humans; Osteoma, Osteoid
PubMed: 33709278
DOI: 10.1007/s00270-021-02804-6 -
American Journal of Rhinology & Allergy Sep 2019
Topics: Combined Modality Therapy; Frontal Sinus; Humans; Nasal Surgical Procedures; Natural Orifice Endoscopic Surgery; Osteoma; Paranasal Sinus Neoplasms; Surgical Flaps
PubMed: 30950282
DOI: 10.1177/1945892419839895 -
Brain & Spine 2022•Metaplastic meningiomas are rare entities, and intracranial osseous subtype are even more rare.•Gross total resection is considered the best treatment... (Review)
Review
•Metaplastic meningiomas are rare entities, and intracranial osseous subtype are even more rare.•Gross total resection is considered the best treatment choice.•Differential diagnosis is mandatory, including osteoma, osteoblastoma, and calcified giant aneurysms.•This rare entity must be considered in a global approach and tailored surgical technique.
PubMed: 36248170
DOI: 10.1016/j.bas.2022.101189 -
Pain Physician Nov 2023Many patients suffer from abdominal and thoracic pain syndromes secondary to numerous underlying etiologies. Chronic abdominal and thoracic pain can be difficult to...
BACKGROUND
Many patients suffer from abdominal and thoracic pain syndromes secondary to numerous underlying etiologies. Chronic abdominal and thoracic pain can be difficult to treat and often refractory to conservative management. In this systematic literature review, we evaluate the current literature to assess radiofrequency ablation's (RFA) efficacy for treating these debilitating chronic pain conditions in the thoracic and abdominal regions.
OBJECTIVES
The objective of this study is to determine the pain relief efficacy of RFA on chronic thoracic and chronic abdominal disease states.
STUDY DESIGN
This study is a systematic literature review that uses the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method to gather academic literature articles through a methodical approach. The numbers obtained from each academic manuscript were then used to calculate the percent efficacy of radiofrequency ablation on thoracic and abdominal pain relief.
METHODS
Articles from 1992 through 2022 were gathered using PRISMA guidelines. The search terms "Radiofrequency Ablation Thoracic Pain" and "Radiofrequency Ablation Abdominal Pain" were used to identify articles to include in our study. Our search yielded a total of 575 studies, 32 of which were included in our study. The articles were then categorized into pain causes. The efficacy of RFA for each qualitative study was then quantified. Risk of bias was also assessed for articles using the Cochran Risk of Bias tool, as well as a tool made by the National Institutes of Health.
RESULTS
The PRISMA search yielded a total of 32 articles used for our study, including 16 observational studies, one cohort study, 6 case reports, 6 case series, and 3 clinical trials. Twenty-five articles were labeled good quality and one article was labeled fair quality according to the risk of bias assessment tools. The studies examined RFA efficacy on chronic abdominal and chronic pain syndromes such as spinal lesions, postsurgical thoracic pain, abdominal cancers, and pancreatitis. Among these etiologies, RFA demonstrated notable efficacy in alleviating pain among patients with spinal osteoid osteomas or osteoblastomas, lung cancer, and pancreatic cancer. The modes of RFA used varied among the studies; they included monopolar RFA, bipolar RFA, pulsed RFA, and RFA at different temperatures. The average efficacy rate was 84% ranging from 55.8% - 100%. A total of 329 males and 291 females were included with ages ranging 4 to 90 years old.
LIMITATIONS
Limitations of this review include the RFA not being performed at the same nerve level to address the same pathology and the RFA not being performed for the same duration of time. Furthermore, the efficacy of RFA was evaluated via large case series and single cohort observational studies rather than control group observational studies and clinical trial studies.
CONCLUSION
A systematic review of the literature supports RFA as a viable option for managing abdominal and thoracic pain. Future randomized controlled trials are needed to investigate the efficacy of the various RFA modalities to ensure RFA is the source of pain relief as a large body of the current literature focuses only on observational studies.
Topics: Male; Female; Humans; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Chronic Pain; Cohort Studies; Pain Management; Radiofrequency Ablation; Abdominal Pain; Chest Pain; Observational Studies as Topic
PubMed: 37976476
DOI: No ID Found -
European Archives of... Feb 2017The objectives of this study were to describe a case of osteoid osteoma arising from the temporal bone manifesting only as first bite syndrome as the sole clinical... (Meta-Analysis)
Meta-Analysis Review
The objectives of this study were to describe a case of osteoid osteoma arising from the temporal bone manifesting only as first bite syndrome as the sole clinical symptom, to perform a meta-analysis of previously reported cases, and to differentiate the clinical characteristics of osteoid osteoma from those of osteoblastoma arising from the temporal bone. In addition to our case, articles addressing osteoid osteoma or osteoblastoma arising from the temporal bone were selected using PubMed, Embase, and the Japan Medical Abstracts Society database (1954 through 2014), with no language preference. The database was searched using the keywords ["osteoid osteoma" OR "osteoblastoma" AND "temporal bone"]. After critical review of 88 studies, 10 cases of osteoid osteoma and 29 cases of osteoblastoma were selected; therefore, including the present case, a total of 40 cases were eligible for qualitative analyses. The mean size of osteoid osteoma was 1.2 cm, which was significantly smaller than that of osteoblastoma (5.1 cm). Radiologically, osteoid osteoma was associated with a lower prevalence of extension into more than two anatomically categorized spaces in comparison with osteoblastoma (P < 0.01). Again, a lower prevalence of erosion of the outer and/or inner tables of the skull in the osteoid osteoma cases was noted (P < 0.05). Conversely, there were no significant differences in the prevalence of representative clinical symptoms, including pain and swelling. According to the present systematic review, osteoid osteoma and osteoblastoma are clinically uniform other than their size or extension.
Topics: Adult; Bone Neoplasms; Facial Neuralgia; Female; Humans; Mastication; Osteoblastoma; Osteoma, Osteoid; Syndrome; Temporal Bone
PubMed: 27106094
DOI: 10.1007/s00405-016-4050-1 -
European Radiology May 2021To systematically review microwave ablation (MWA) protocols, safety, and clinical efficacy for treating bone tumors. (Review)
Review
AIM
To systematically review microwave ablation (MWA) protocols, safety, and clinical efficacy for treating bone tumors.
MATERIALS AND METHODS
A systematic literature search was conducted using PubMed, the Cochrane Library, EMBASE, and Web of Science database. Data concerning patient demographics, tumor characteristics, procedure, complications, and clinical outcomes were extracted and analyzed.
RESULTS
Seven non-comparative studies (6 retrospective, 1 prospective) were included accounting for 249 patients and 306 tumors (244/306 [79.7%] metastases; 25/306 [8.2%] myelomas, and 37/306 [12.1%] osteoid osteomas [OO]). In malignant tumors, MWA power was 30-70 W (except in one spinal tumors series where a mean power of 13.3 W was used) with pooled mean ablation time of 308.3 s. With OO, MWA power was 30-60 W with mean ablation time of 90-102 s. Protective measures were very sporadically used in 5 studies. Additional osteoplasty was performed in 199/269 (74.0%) malignant tumors. Clinically significant complications were noted in 10/249 (4.0%) patients. For malignant tumors, estimated pain reduction on the numerical rating scale was 5.3/10 (95% confidence intervals [95%CI] 4.6-6.1) at 1 month; and 5.3/10 (95% CI 4.3-6.3) at the last recorded follow-up (range 20-24 weeks in 4/5 studies). For OO, at 1-month follow-up, effective pain relief was noted in 92.3-100% of patients.
CONCLUSION
MWA is effective in achieving pain relief at short- (1 month) and mid-term (4-6 months) for painful OO and malignant bone tumors, respectively. Although MWA seems safe, further prospective studies are warranted to further assess this aspect, and to standardize MWA protocols.
KEY POINTS
• Large heterogeneity exists across literature about ablation protocols used with microwave ablation applied for the treatment of benign and malignant bone tumors. • Although microwave ablation of bone tumors appears safe, further studies are needed to assess this aspect, as current literature does not allow definitive conclusions. • Nevertheless, microwave ablation is effective in achieving pain relief at short- (1 month) and mid-term (4-6 months) for painful osteoid osteomas and malignant bone tumors, respectively.
Topics: Ablation Techniques; Bone Neoplasms; Catheter Ablation; Humans; Microwaves; Prospective Studies; Radiofrequency Ablation; Retrospective Studies; Treatment Outcome
PubMed: 33155107
DOI: 10.1007/s00330-020-07382-8 -
Spine Oct 2016Clinically based systematic review. (Review)
Review
STUDY DESIGN
Clinically based systematic review.
OBJECTIVE
To determine the role of (A) medical treatment and (B) interventional radiology as either adjuvant or stand-alone treatment in primary benign bone tumors of the spine.
METHODS
A multidisciplinary panel of spine surgeons, radiation oncologists, and medical oncologists elaborated specific focused questions regarding aneurysmal bone cyst, giant cell tumor, and osteoid osteoma. Denosumab, bisphosphonate, interferon, bone marrow aspirate, doxycycline, thermal ablation, and selective arterial embolization were identified as areas of interest for the article. A systematic review was performed through MEDLINE and EMBASE. Recommendations based on the literature review and clinical expertise were issued using the GRADE system.
RESULTS
The overall quality of the literature is very low with few multicenter prospective studies. For giant cell tumor, combination with Denosumab identified 14 pertinent articles with four multicenter prospective studies. Nine studies were found on bisphosphonates and six for selective arterial embolization. The search on aneurysmal bone cyst and selective arterial embolization revealed 12 articles. Combination with Denosumab, Doxycycline, and bone marrow aspirate identified four, two, and three relevant articles respectively. Eleven focused articles were selected on the role of thermal ablation in osteoid osteoma.
CONCLUSION
Alternative and adjuvant therapy for primary benign bone tumors have emerged. Their ability to complement or replace surgery is now being scrutinized and they may impact significantly the algorithm of treatment of these tumors. Most of the data are still emerging and further research is desirable. Close collaboration between the different specialists managing these pathologies is crucial.
LEVEL OF EVIDENCE
N/A.
Topics: Antineoplastic Agents; Bone Cysts, Aneurysmal; Combined Modality Therapy; Diphosphonates; Doxycycline; Embolization, Therapeutic; Giant Cell Tumor of Bone; Humans; Osteoma, Osteoid; Radiology, Interventional; Spinal Neoplasms; Treatment Outcome
PubMed: 27488295
DOI: 10.1097/BRS.0000000000001818 -
Ophthalmic Plastic and Reconstructive...The purpose of this study was to describe the clinical characteristics, management, and outcomes of orbital osteomas in the pediatric age group, and compare these to...
PURPOSE
The purpose of this study was to describe the clinical characteristics, management, and outcomes of orbital osteomas in the pediatric age group, and compare these to osteomas managed in the adult population.
METHODS
A retrospective review of 3 cases of rapidly progressive orbital osteomas in young patients was performed. In addition, a systematic review of the literature following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines was conducted to describe the clinical characteristics, management, and outcomes of orbital osteomas in the pediatric age group. The PubMed/MEDLINE database was searched in December 2019 for studies reporting data on patients with orbital osteomas.
RESULTS
Fifty-nine patients were included in this pediatric review, 39 male patients (68%), 18 female patients (32%), and 2 cases with unreported genders. Average age was 15.9 years with a range of 4-21 years. Average osteoma size measured 30.7 mm with a range of 9-60 mm. Adult osteoma size for comparison was smaller than 10 mm in majority of cases. The most common location of pediatric osteomas was the ethmoid sinus. The frontal sinus was the most common location in adult patients. Ninety-seven percent of reported pediatric cases required surgical intervention, compared with only 6.5% in adults.
CONCLUSIONS
Orbital osteomas in younger patients are larger when identified, grow faster, are more likely to be symptomatic, and more likely to require surgical intervention compared with those identified in older patients. We recommend close monitoring of osteomas identified in young patients as well as counseling regarding the potential need for future resection.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Endoscopy; Female; Frontal Sinus; Humans; Male; Osteoma; Paranasal Sinus Neoplasms; Retrospective Studies; Young Adult
PubMed: 32932409
DOI: 10.1097/IOP.0000000000001755 -
Acta Radiologica (Stockholm, Sweden :... Apr 2018Background Ribbing disease, or multiple diaphyseal sclerosis, is a rare benign bone dysplasia. Purpose To systematically review the literature to determine the clinical...
Background Ribbing disease, or multiple diaphyseal sclerosis, is a rare benign bone dysplasia. Purpose To systematically review the literature to determine the clinical and radiological presentation of patients with Ribbing disease as well as the effects of attempted treatments. Material and Methods We considered individual patient data of patients diagnosed with Ribbing disease derived from patient reports and patient series. All stages of the review were performed by two reviewers independently. Standard descriptive statistics were used for quantitative analyses and mixed model analyses were used when appropriate Results The literature search yielded 420 unique hits of which 23 studies were included, covering a total of 40 patients of whom 29 had bilateral involvement. The mean age at diagnosis was 35 years and the mean time between diagnosis and onset of symptoms, mostly pain, was five years (range = 1-16 years). The tibial diaphysis was the most commonly involved bone in 35 of 36 patients. Non-surgical treatment consisted of non-steroidal anti-inflammatory drugs (NSAIDs), prednisone, and bisphophonates with mixed results. Surgical treatment consisted of intramedullary reaming and fenestration and was very effective to reduce pain. Conclusion The clinical presentation and imaging findings of patients with Ribbing disease are becoming more apparent. However, there is paucity of evidence on the natural disease progression and effectiveness of treatment modalities.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Camurati-Engelmann Syndrome; Female; Glucocorticoids; Humans; Magnetic Resonance Imaging; Male; Osteoma, Osteoid; Prednisone; Tibia; Tomography, X-Ray Computed; X-Rays
PubMed: 28691528
DOI: 10.1177/0284185117719575 -
The Journal of Foot and Ankle Surgery :... May 2019Osteoid osteomas (OOs) are rare benign bone tumors that may occur in various joints including the ankle. These tumors are generally removed via open surgical excision or...
Osteoid osteomas (OOs) are rare benign bone tumors that may occur in various joints including the ankle. These tumors are generally removed via open surgical excision or radiofrequency ablation. However, when they occur intra-articularly, these treatments are more difficult to perform because of more difficult access and the increased risk of damaging articular cartilage. Therefore, some have advocated for the use of arthroscopy to treat these cases. This systematic review aims to investigate the safety and efficacy of arthroscopic treatment for intra-articular OO of the ankle. Using Medline and Embase, we systematically reviewed the literature as of May 31, 2017. All articles published on and before that date were reviewed by 2 independent reviewers. Seventeen articles containing a total of 27 cases were included in the review. Most reported cases were in the talar neck, followed by the distal tibia. Of all the cases, only 2 recurrences were reported (in the same patient), and no complications were reported. Therefore, these cases demonstrate arthroscopic excision of intra-articular OO of the ankle as a safe and effective alternative to open surgical excision and radiofrequency ablation, with a success rate of 96%. However, all articles found were case studies or small case series owing to the rarity of this disease. In the future, analyses of case series with larger case collections should be performed.
Topics: Ankle Joint; Arthroscopy; Bone Neoplasms; Humans; Neoplasm Recurrence, Local; Osteoma, Osteoid
PubMed: 30910487
DOI: 10.1053/j.jfas.2018.10.001