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Interstitial laser photocoagulation for the treatment of osteoid osteoma

RESULTS OF A PROSPECTIVE STUDY

J. D. Witt, FRCS Orth, Consultant Orthopaedic Surgeon1; M. A. Hall-Craggs, FRCR, Consultant Radiologist1; P. Ripley, PhD, Physicist2; J. P. Cobb, FRCS, Consultant Orthopaedic Surgeon1; and S. G. Bown, FRCP, Professor of Laser Medicine2

1 The London Bone and Soft Tissue Tumour Service, The Middlesex Hospital and University College London Hospitals NHS Trust, Mortimer Street, London W1N 8AA, UK.
2 National Medical Laser Centre, University College London Medical School, Charles Bell House, 67-73 Riding House Street, London W1P 7LD, UK.

Correspondence should be sent to Mr J. D. Witt.

We report the results of a prospective study of 23 patients in which interstitial laser photocoagulation (ILP) was used to treat an osteoid osteoma. ILP is a technique in which tumour tissue is destroyed by direct heating using low-power laser light energy delivered by thin (400 µm) optical fibres which are introduced percutaneously into the tumour under image guidance.

Pain was evaluated before operation and at the latest follow-up using a visual analogue scale with 0 denoting no pain and 10 the worst pain imaginable. The mean follow-up was for 15 months.

The results showed that the mean pain score decreased from 7.5 before operation to 0.95 at the latest follow-up. Fourteen patients had no pain and eight had minor discomfort, not requiring analgesia. One patient required a second procedure because placement of the fibre had not been accurate enough and one developed recurrent symptoms eight months after treatment. All patients were satisfied with the operation because of the rapid resolution of pain, the minimally invasive nature of the procedure, and the fact that there was no postoperative restriction of activity.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General