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Pain Relief and Imaging Improvement in Gammagraphy in Osteoid Osteoma after Etoricoxib Treatment in 20 Patients

Volume 6 - Issue 2

José Carlos Minarro1*, Carlos Alfonso-Bravo1, Alberto Izquierdo-Fernández1, María Teresa Urbano-Luque2 and Pedro Carpintero-Benítez1

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    • 1Department of Orthopedic Surgery, Hospital Reina Sofía, Córdoba, Spain
    • 2Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain

    *Corresponding author: José Carlos Minarro, Department of Orthopedic Surgery, Hospital Reina Sofía, Córdoba, Spain

Received: June 14, 2018;   Published: June 27, 2018

DOI: 10.26717/BJSTR.2018.06.001312

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Abstract

Purpose:Pain in Osteoid osteoma has always been treated with Non Steroid Anti-Inflammatory Drugs (NSAIDs) with satisfactory results. Recent researches reveal that pain is related to cyclooxigenase-2 (COX-2) secretion. The objective of this paper is to evaluate the pain response in patients with Osteoid osteoma after the administration of a selective COX-2 inhibitor (Etoricoxib).

Methods:A prospective study was made of consecutive patients diagnosed in our centre for Osteoid osteoma between January 2010 and December 2016. A total of 20 patients were enrolled (15 men and 5 women). Pain was collected in 3 stages: 1) treatment with NSAIDs 2) 1 month after treatment with Etoricoxib and 3) Final pain, 2 years after inclusion in the study. A Visual Analogue Scale (VAS) was used to determine the pain. Six months after starting treatment, possible gammagraphy changes due to treatment were assessed in patients who refused surgical treatment by radiofrequency (RFA).

Results: One month after treatment with Etoricoxib the nocturnal pain improved from 1.85 ± 0.59 to 0.93 ± 0.41, and the diurnal pain improved from 1.58 ± 0.50 to 0.40 ± 0.30 compared to when they were taking conventional NSAIDs (p<0.05). Gammagraphy was assessed in five of the patients finding no trazer uptake. Final VAS found no pain differences between those patients who underwent RFA and those who did not.

Conclusion: Treatment of Osteoid osteoma with Etoricoxib is more effective than conventional NSAIDs, and may be a better treatment for those patients who refuse a surgical treatment or if it is not indicated due to excessive morbidity.

Keywords: Pain; Osteoid Osteoma; Gammagraphy; Etoricoxib; Treatment; Radiofrequency; Cyclooxigenase-2; COX-2

Abbreviations: NSAIDs: Non Steroid Anti-Inflammatory Drugs; COX-2: Cyclooxigenase-2; VAS: Visual Analogue Scale; RFA: Radio Frequency Ablation

Abstract| Introduction| Materials and Methods| Results| Discussion| Conclusion| References|