Bone ablation using image guidance

Bone ablation

A special needle is inserted into the tumor. A laser fibre is then passed through the needle. Heat from the tip of the laser fibre is used to destroy the osteoid osteoma.

What is a bone ablation?

Bone ablation is a procedure where an interventional radiologist uses heat to treat a benign bone tumour called an osteoid osteoma. This abnormal area is painful and the ablation will help ease the pain.

Bone ablation is done using image guidance by an interventional radiologist.

How a bone ablation is done

The interventional radiologist uses ultrasound, X-rays or computed tomography (CT) to identify the part of the bone that needs to be treated.

A special needle is then put into the area that needs treatment.

Next a laser fibre is put through the needle, activated and used to burn the osteoid osteoma.

Sometimes, a small piece of the bone may be removed (bone biopsy) if the doctor thinks that it needs to be looked at under a microscope.

The procedure usually takes about two hours.

Risks of a bone ablation

Bone ablation is usually a low-risk procedure. The risk may increase depending on your child’s condition, age and health, and the location of the lesion.

The risks of a bone ablation can include:

  • skin burn
  • infection (bone, joint or skin)
  • fracture (break) of the bone
  • blood vessel or nerve damage
  • injury to any organ nearby

Visiting the interventional radiologist before the procedure

Your child will have a clinic visit with the interventional radiologist before the procedure. During the visit you should expect:

  • A health assessment to make sure your child is healthy and that it is safe to have general anaesthesia and to go ahead with the procedure.
  • An overview of the procedure, and a review of the consent form with an interventional radiologist.
  • Blood work, if needed.

Giving consent before the procedure

Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and potential benefits of the bone ablation and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.

How to prepare your child for the procedure

Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.

Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.

If your child becomes ill within two days before the procedure

It is important that your child is healthy on the day of their procedure. If your child starts to feel unwell or has a fever within two days before the bone ablation, let your doctor know. Your child’s procedure may need to be rebooked.

Food, drink, and medicines before the procedure

  • Your child’s stomach must be empty before a sedation or general anaesthetic.
  • If your child has special needs during fasting, talk to your doctor to make a plan.
  • Your child can take their regular morning medicine with a sip of water two hours before the procedure.
  • Medicines such as acetylsalicylic acid (ASA), naproxen or ibuprofen, warfarin, or enoxaparin may increase the risk of bleeding. Do not give these to your child before the procedure unless they have been cleared first by their doctor and the interventional radiologist.

Your child will have medicine for pain

Children are given medicine for treatments that may be frightening, uncomfortable or painful. For bone ablations, most children are given general anesthesia and local anesthesia at the site of the procedure to make sure they are comfortable. The type of medicine that your child will have for the procedure will also depend on your child’s condition.

On the day of the bone ablation

Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the bone ablation and the anaesthetist who will be giving your child medication to make them comfortable for the procedure.

During the bone ablation, you will be asked to wait in the surgical waiting area.

After the bone ablation

Once the bone ablation is complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you.

Many children will feel less pain immediately after the procedure. In some children, it can take up to two weeks to see an improvement in their pain.

Going home

Most children who have had a bone ablation go home the same day. If your child’s doctor has arranged this, your child will be ready to go home about six hours after the procedure. Some children may need to stay overnight in the hospital.

For more details on how to care for your child after a bone ablation, see Bone ablation: Caring for your child at home after the procedure.

Follow-up

A follow-up clinic visit about two weeks after the procedure will be arranged.

Key points

  • A bone ablation is a procedure where a doctor uses heat to treat a benign bone growth called an osteoid osteoma. This abnormal area is painful and the ablation will help ease the pain.
  • Bone ablation is usually a low-risk procedure.
  • Most children can go home on the same day as the procedure.

Candice Sockett, RN(EC), MN:APN

Michelle Cote BScN RN

Joao Amaral, MD

2/9/2016

At SickKids

At SickKids, the interventional radiologists work in the Department of Diagnostic Imaging – Division of Image Guided Therapy (IGT). You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.

For more information on fasting see Eating and drinking before surgery.

For more information on preparing your child for their procedure see Coming for surgery.





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