Innovative Minimally Invasive Surgical Procedures for Bone Tumors

Percutaneous radiofrequency ablation updated 12/30/06

Percutaneous radiofrequency ablation or PRA,  is a new technique that has been used extensively for soft tissue lesions and has been applied to one special type of bone tumor known as osteoid osteoma. This benign bone tumor is small but very painful, an it may be very deep within a bone where conventional surgical exposure of the tumor would require a large incision and a painful dissection.   Since the tumor is often so small, a new technique is now available which allows the tumor to be eliminated via a needle.  Surgery is no longer needed in these cases, and patients spend hours in the hospital and days recovering as opposed to days in the hospital and months recovering.

The PRA technique usually involves general anaesthesia administered by an anesthesiologist.  As shown in the images at right, the patient has an osteoid osteoma in the proximal femur, where a conventional surgical removal would require an extensive dissection. The patient is positioned in a CT scanner and the nidus or core of the lesion is identified.  A thin needle is placed into the center of the tumor and a biopsy is taken.  The needle is replaced by a special thin probe, which is then connected to a radiofreqency generator.  This results in the tip of the needle becoming mildly hot for a few minutes.  The heat kills the tumor cells and the procedure is over in a few minutes. The patient's pain is often gone by the time he or she leaves the hospital that day.

PRA may also be applied to small soft tissue tumors in very limited cases, and it may have oher uses as well. This technique shows promise for the future.

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