A 24 years old otherwise healthy male presented with continuous lumbar spine pain in a focal spot of L3/L4 on the right. High doses of nonsteroidal painkillers are efficient only for a short period of time and several side effects such as stomach pain are present.

CT imaging revealed a focal mixed lytic-sclerotic lesion in the right lower articular process of L3 vertebra, consistent with osteoid osteoma (picture 1).

Local CT-guided microwave ablation treatment was performed under general anesthesia with the patient lying in the prone position.

Before the microwave ablation procedure, a lesion biopsy was performed to obtain the correct diagnosis of the treated lesion (picture 2).

Subsequently, lesion ablation was performed using a TATOpro 18 gauge, 20 centimeters microwave antenna. 10 Watts of energy was applied for 5 minutes (picture 3).

No type of dissection was performed despite the small distance from the nerve roots, since the presence of a cortical bone wall between the lesion and vulnerable structures was considered protective.

1. Lower back pain disappeared immediately after the procedure and the patient was discharged home the next day.
2. At the first follow-up (1 month), pain was absent and the patient was not requiring pain therapy.