Osteoblastoma is a benign bone-forming tumour characterised by progressive nocturnal bone pain. When active treatment is indicated, the choice of approach depends on lesion location, anatomy, and proximity to critical structures.
The established first-line approach involves percutaneous thermoablation, with CT-guided radiofrequency ablation (RFA) recognised as the primary technique. The full protocol specifies procedural requirements, mandatory safety distances, the conditions under which thermal protection measures must be applied, and the alternative ablation modalities available for specific anatomical situations.
For these reasons, today the treatments of choice of these lesions are represented by percutaneous thermoablation techniques, among which Radiofrequency ablation under CT-guidance (RFA) is the gold standard.
Currently, Radiofrequency ablation (RFA) under CT-guidance is accepted as the gold standard treatment for OB, even when presenting in the spine, where, if necessary, it is used with thermal protection techniques.
Nocturnal pain symptoms recede immediately, but an infusion pump of analgesic drugs is often necessary during the first hours.