[1]计忠宇 于鸿 尹同珍 程继博 杨锦昌 周龙龙.骨科机器人引导经皮穿刺射频消融治疗骨样骨瘤14例[J].中国中医骨伤科杂志,2025,33(09):75-79.[doi:10.20085/j.cnki.issn1005-0205.250914]
　JI Zhongyu YU Hong YIN Tongzhen CHENG Jibo YANG Jinchang ZHOU Longlong.Orthopedic Robotic-Guided Percutaneous Puncture Radiofrequency Ablation Treatment of 14 Cases of Osteoid Osteoma[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(09):75-79.[doi:10.20085/j.cnki.issn1005-0205.250914]
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骨科机器人引导经皮穿刺射频消融治疗骨样骨瘤14例()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年09期
页码:
75-79
栏目:
临床报道
出版日期:
2025-09-15

文章信息/Info

Title:
Orthopedic Robotic-Guided Percutaneous Puncture Radiofrequency Ablation Treatment of 14 Cases of Osteoid Osteoma
文章编号:
1005-0205(2025)09-0075-05
作者:
计忠宇1 于鸿1 尹同珍1 程继博1 杨锦昌1 周龙龙1
1河北省沧州中西医结合医院(河北 沧州,061001)
Author(s):
JI Zhongyu1 YU Hong1 YIN Tongzhen1 CHENG Jibo1 YANG Jinchang1 ZHOU Longlong1
1Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine in Hebei Province,Cangzhou 061001,Hebei China.
关键词:
骨样骨瘤;  皮质型;  骨科机器人;  射频消融;  微创
Keywords:
osteoid osteoma;  pachyderma;  orthopedic robot;  radiofrequency ablation;  minimally invasive
分类号:
R738.1
DOI:
10.20085/j.cnki.issn1005-0205.250914
文献标志码:
B
摘要:
目的:探讨骨科机器人引导经皮穿刺射频消融治疗骨样骨瘤手术的有效性和安全性。方法:回顾性分析2023年1月至2024年6月符合纳入标准的14例骨样骨瘤患者临床资料,其中男9例,女5例; 年龄为8～16岁,平均为14.2岁。术前所有患者完善X线、CT及MRI检查。术中应用骨科机器人行瘤巢定位并设计穿刺路径,避开神经、血管打入一枚直径1.5 mm克氏针至瘤巢,经克氏针引导骨穿刺针进行穿刺活检,经活检通道将射频针导入瘤巢,射频消融瘤巢。采用疼痛视觉模拟量表(VAS)评分进行术前及术后疼痛评价。结果:14例患者均顺利完成手术,术后组织病理学检查确认均为骨样骨瘤。患者术后疼痛显著减轻,术后3个月与术前疼痛VAS评分差异有统计学意义(P<0.05); 患者平均住院时间为3 d,术后无神经、血管损伤,皮肤穿刺针孔无感染,无病理性骨折,无复发及并发症; 随访时间平均为12个月(10～18个月),末次随访未见肿瘤复发和出现疼痛。结论:骨科机器人引导经皮穿刺射频消融治疗骨样骨瘤具有术中定位精准、瘤巢射频消融彻底、副损伤小、住院时间短的优势。
Abstract:
Objective:To explore the effectiveness and safety of percutaneous radiofrequency ablation for osteoid osteoma surgery guided by orthopedic robot.Methods:The clinical data of 14 patients with osteoid osteoma who met the inclusion criteria from January 2023 to June 204 were retrospectively analyzed,including 9 males and 5 females,aged 8 to 16 years old,with an average age of 14.2 years old.All patients underwent X-ray,CT,and MRI examinations before surgery.During surgery,the orthopedic robot was used to locate the tumor nest and design the puncture path,the nerves and blood vessels,and 1.5 mm diameter Kirschner needle was inserted into the tumor nest,and a bone biopsy needle was inserted for biopsy through Kirschner needle,and the radiofrequency needle was inserted into the tumor nest through the biopsy channel,and the tumor nest was ablated by radiofrequency.The visual analogue scale(VAS)score was used to evaluate pain before and after surgery.Results:All 14 patients successfully completed the operation,and the postoperative histopathological confirmation was osteoid osteoma in 14 cases.Postoperative was significantly relieved in all patients,and the comparison of VAS score of pain before and within 3 months after operation showed a significant difference(P<0.05).The average hospital stay of patients was 3 d,and there was no nerve,vascular injury,no infection of skin puncture needle hole,no pathological fracture,recurrence and other complications after operation,and the average follow-up period of 12 months(1018 months)was obtained,and no recurrence of tumor and of pain were seen at the last follow-up.Conclusion:Orthopedic robot-guided percutaneous puncture radiofrequency ablation for osteoid osteoma has the advantages of accurate intraoperative positioning,thorough ablation of tumor nest,less collateral damage,and short hospital stay.

参考文献/References:

[1] MEYE J,PRIEMEL M,ROLVIEN T,et al.The diagnostic challenge of osteoid osteoma in the bones of the hand:a case series[J].Diagnostics(Basel),2023,13(7):1279.
[2] IZZO A,ZUGARO L,FASCETTI E,et al.Management of osteoblastoma and giant osteoid osteoma with percutaneous thermoablation techniques[J].J Clin Med,2021,10(24):5717.
[3] SAGOO N S,HAIDER A S,CHEN A L,et al,Radiofrequency ablation for spinal osteoid osteoma:a systematic review of safety and treatment outcomes[J].Surg Oncol,2022,41:101747.
[4] SHANMU GASUNDARAM S,NADKARNI S,KUMAR A,et al.Percutaneous ablative therapies for the management of osteoid osteomas:a systematic review and meta-analysis[J].Cardiovasc Intervent Radiol,2021,44(5):739-749.
[5] 傅颖颖,颜方方,柳方,等.关节囊内骨样骨瘤影像学表现及分析[J].临床放射学杂志,2021,40(3):570-574.
[6] ACANFORA C,GRASSI E,GIACOBBE G,et al.Post-procedural follow-up of the interventional radiology's management of osteoid osteomas and osteoblastomas[J].J Clin Med,2022,11(7):1987.
[7] BOSCAINOS P J,COVSINS G R,KVLSHRESHTHA R,et al.Osteoid osteoma[J].Orthopedics,2013,36(10):792-800.
[8] GIAMMALVA G R,DELL'AGLIO L,GUARRERA B.et al.Transnasal endoscopic approach for osteoid osteoma of the odontoid process in a child:technical note and systematic review of the literature[J].Brain Sci,2022,12(7):916.
[9] FAN M,FANG Y,ZHANG Q,et al.A prospective cohort study of the accuracy and safety of robot-assisted minimally invasive spinal surgery[J].BMC Surg,2022,22(1):47.
[10] DALILI D,DALILI D E,ISAAC A,et al.Treatment of osteoid osteoma[J].Semin Intervent Radiol,2023,40(1):100-105.
[11] IWAI T,OEBISU N,HOSHI M,et al.Finite element analysis could predict and bevent a pathdogical femoral snaft fracture after en bloc resection of a large osteoid osteoma[J].Children(Basel),2022,9(2):158.
[12] 李佳鸿,林书,唐六一,等.骨科机器人辅助下经皮固定小切口减压术治疗晚期胸腰椎转移瘤[J].中国修复重建外科杂志,2023,37(9):1113-1118.
[13] TANINO H,MITSUTAKE R,TAKAYI K,et al.Does a commercially available augmented reality-based portable hip navigation system improve cup positioning during THA compared with the conventional technique?A randomized controlled study[J].Clin Orthop Relat Res,2024,482(3):458-467.
[14] 吴敏,官建中,陈笑天,等.髋臼下螺钉植入技术在髋臼骨折中的应用体会[J].中国修复重建外科杂志,2024,38(9):1040-1046.
[15] 方建文,王达辉,郑一鸣.儿童关节内近关节与关节外骨样骨瘤的特点及手术疗效分析[J].临床小儿外科杂志,2020,19(9):821-824.
[16] ALQAHTANI S M,ALBADRAN A A,ALTALIB A,et al.Osteoid osteoma of the proximal humerus:a case report and literature review[J].Saudi J Med Med Sci,2023,11(2):178-182.
[17] YALCINKAYA U,DOGANAVSARGIL B,SEZAK M,et al.Clinical and morphological characteristics of osteoid osteoma and osteoblastoma:a retrospective single-center analysis of 204 patients[J].Ann Diagn Pathol,2014,18(6):319-325.
[18] CIVINO A,DIOMEDA F,GIORDANO L,et al.Intra- and juxta-articular osteoid osteoma mimicking arthritis:case series and literature review[J].Children(Basel),2023,10(5):829.
[19] MASELLI F,STORARI L,LORUSSO M,et al.Osteoid osteoma in an adult wheelchair basketball player mimicking musculoskeletal shoulder pain:red flag or a red herring?[J].Tomography,2022,8(1):389-401.
[20] CARNEIRO B C,DA CRUZ I A N,ORMOND FILHO A G,et al.Osteoid osteoma:the great mimicker[J].Insights Imaging,2021,12(1):32.
[21] GRYGLEWSKI K,NAPORA J,WAEJKO S,et al.Recent advances on diagnosis and treatment of osteoid osteoma[J].Pol Orthop Traumatol,2022,87(1):25-31.
[22] 刘会攀,刘林,张伟,等.骨样骨瘤全身骨显像和SPECT/CT显像的图像特征分析[J].中华核医学与分子影像杂志,2020,40(1):11-15.
[23] 张殿星,孙博,巩武贤.长骨皮质型骨样骨瘤的影像学表现与鉴别诊断[J].医学影像学杂志,2024,34(10):120-124.
[24] 肖林,胡剑波,吴泽文.30例影像学表现类似骨样骨瘤病变的鉴别诊断[J].肿瘤基础与临床,2015,28(1):56-58.
[25] BANGA K,RACANO A,AYENI O R,et al.A typical hip pain:coexistence of femoracetabular impingement(FAI)and osteoid osteoma[J].Knee Surg Sports Traumatol Arthroscy,2015,23(5):1571-1574.
[26] BROWN M,GREEN D.Pain management in osteoid osteoma:a review of surgical and non-surgical options[J].Pain Med,2020,21(6):1050-1058.
[27] LINDQUESTER W,CROWLEY J,HAWKINS C.Percutaneous thermal ablation for treatment of osteoid osteoma:a systematic review and analysis[J].Skeletal Radiol,2020,49(9):1403-1411.
[28] SUTHERLAND G R,MCBETH P B.Robot-assisted surgery:a review of applications and outcomes[J].Int J Med Robot,2021,17(4):e2245.
[29] 杨勇昆,刘巍峰.骨科机器人辅助技术在骨肿瘤手术中的应用现状[J].中华骨科杂志,2023,43(5):337-342.
[30] WANG T L,LUO Y P,ZHOU Z F,et al.O-arm-navigated,robot-assisted versus conventional CT guided radiofrequency ablation in treatment of osteoid osteoma:a retrospective cohort study[J].Front Surg,2022,9:881852.
[31] PARMEGGIANI A,MARTELLA C,CECCARELL L,et al.Osteoid osteoma:which is the best mininvasive treatment option?[J].Eur J Orthop Surg Traumatol,2021,31(8):1611-1624.
[32] 徐海荣,李远,单华超.机器人辅助与导航辅助治疗骨样骨瘤的回顾性队列研究[J].首都医科大学学报,2024,45(5):795-800.
[33] FRIDLEY J S,WOLINSKY J P.Safety and precision in robot-assisted tumor resections:clinical outcomes[J].Int J Med Robot,2023,19(2):e2374.
[34] ZHANG H,CHEN J.Advances in robot-assisted surgery for bone tumors:a review[J].J Bone Oncol,2023:100359.
(收稿日期:2025-05-01)

更新日期/Last Update: 2025-09-15