1. Radiofrequency ablation of L2-L3 Facet joint osteoblastoma
Kelekis, DK Filippiadis
2nd Radiology Dpt,
University General Hospital “ATTIKON”, Athens/GR

2. CASE REPORT
18 y-o male patient reports low back pain during the last 6 months exacerbating during night time and relieved with salicylates
CT scan illustrates a lesion of the left L2-L3 facet joint

3. CASE REPORT CT-guided percutaneous biopsy was performed
Lesion was proven to be an osteoblastoma

4. TECHNIQUE CT-guided RFA was planned
A 22 Gauge spinal needle was inserted in the epidural space and air was injected via an antimicrobial filter
By means of an electronic drill a bone access needle was inserted in the lesion
Coaxially a bipolar RF electrode was inserted
Recording of evoked potentials was used during ablation session

5. TECHNIQUE A 22 Gauge spinal needle was inserted in
the epidural space and air was injected
via an antimicrobial filter

6. TECHNIQUE
By means of an electronic drill a bone access needle was inserted in the lesion

7. TECHNIQUE
Recording of evoked potentials was used during ablation session

8. CASE REPORT
5 years post ablation patient is pain free and bone formation is illustrated at the lesion level

9. Q1: Propose potential ablation modes for the treatment of osteoblastoma
Radiofrequency ablation (RFA)
Plasma energy ablation (coblation)
Microwave ablation (MWA)
Cryoablation
MR-guided HIFU
All the above can be used

10. Q1: Propose potential ablation modes for the treatment of osteoblastoma
Radiofrequency ablation (RFA)
Plasma energy ablation (coblation)
Microwave ablation (MWA)
Cryoablation
MR-guided HIFU
All the above can be used (RIGHT ANSWER)

11. Q2: Would you consider thermal protection techniques during ablation in the spine?
No thermal protection is required
Passive thermal protection
Thermocouples
Intra-operative neurological monitoring systems (neurodiagnostic EEG, EMG and evoked potential electrodes and accessories)
Active thermal protection - insulation
CO2, air
Hydrodissection
Skin warming
Combination of both

12. Q2: Would you consider thermal protection techniques during ablation in the spine?
No thermal protection is required
Passive thermal protection
Thermocouples
Intra-operative neurological monitoring systems (neurodiagnostic EEG, EMG and evoked potential electrodes and accessories)
Active thermal protection - insulation
CO2, air
Hydrodissection
Skin warming
Combination of both (RIGHT ANSWER)