📖 Overview
Percutaneous CT-guided bone tumour ablation treats both benign bone tumours (osteoid osteoma) and malignant bone lesions (primary or metastatic). Under CT guidance, ablation probes are inserted through the cortex to the tumour nidus and destroy it by heat (radiofrequency, microwave) or cold (cryoablation) — without open surgery.
At Cochin AP-HP, bone ablation is performed by senior interventional radiologists with extensive experience. Osteoid osteoma cure rate: 95% in a single session. No incision. Short general anaesthesia. Same-day discharge in most cases.
🎯 Indications
- Osteoid osteoma — benign bone tumour causing severe night pain, relieved by aspirin. Gold standard treatment: CT-guided radiofrequency ablation. 95% cure in 1 session.
- Bone metastases — pain palliation by cryoablation or RFA. Significant pain reduction in 70–80% of patients within 4 weeks.
- Primary bone tumours — pre-operative embolization or ablation
- Vertebral metastases — cementoplasty ± ablation for pain and stabilisation
🔧 Techniques
🌡️ Radiofrequency ablation (RFA)
Gold standard for osteoid osteoma. Electrode inserted percutaneously to the nidus under CT guidance. Heated to 90°C for 4–6 minutes. 95% cure rate in a single session. General anaesthesia.
❄️ Cryoablation
Preferred for bone metastases near nerves, spinal cord, or skin. Ice ball visible on CT allows precise margin control.
🏗️ Cementoplasty (vertebroplasty)
Bone cement injection into painful lytic metastases or osteoporotic fractures to stabilise and reduce pain. Can be combined with ablation.
🔬 CT-guided bone biopsy
Combined with ablation in same session if histological confirmation is required before treatment.