PAIN ALLEVIATION DYNAMICS FOLLOWING CT-GUIDED MICROWAVE ABLATION OF OSTEOID OSTEOMA

Abstract

Objectives: To evaluate the effectiveness of CT-guided microwave ablation (MWA) in alleviating pain and improving clinical outcomes in patients with osteoid osteoma, and to assess procedural success, recurrence, and complication rates following treatment.

Methodology: This prospective observational study was conducted at a tertiary care healthcare institution and included 28 patients with clinically and radiologically confirmed osteoid osteoma who underwent CT-guided microwave ablation. Demographic characteristics, lesion features, symptom duration, analgesic dependency, and Numerical Rating Scale (NRS) pain scores were recorded. The procedure was performed under CT guidance using standardized institutional protocols. Patients were followed for 3 months to evaluate pain relief, procedural success, recurrence, repeat intervention, and complications. Data were analyzed using SPSS version 20. Quantitative variables were expressed as mean ± standard deviation, while qualitative variables were presented as frequencies and percentages. Changes in pain scores before and after treatment were assessed using paired statistical tests, with a p-value <0.05 considered statistically significant.

Results: The mean age of patients was 19.2 ± 6.1 years, with males comprising 67.9% of the study population. The femur was the most common lesion site (53.6%). Nocturnal pain was present in 96.4% of patients, and 89.3% reported regular analgesic use prior to treatment. The mean pre-procedural NRS score was 8.5 ± 0.9, which significantly decreased to 1.1 ± 0.8 following ablation (p < 0.001). The mean time to pain relief was 5.3 ± 2.4 days. Procedural success was achieved in 96.4% of patients. Recurrence occurred in one patient (3.6%) during the 3-month follow-up, who underwent repeat microwave ablation with satisfactory clinical improvement. Minor complications occurred in one patient (3.6%), while no major procedure-related complications were observed.

Conclusion: CT-guided microwave ablation is a safe, effective, and minimally invasive treatment for osteoid osteoma, providing rapid and significant pain relief with a high clinical success rate, a low recurrence rate at 3 months, and minimal complications. These findings support CT-guided microwave ablation as a reliable minimally invasive treatment option for osteoid osteoma.