We report a 24-year-old male who was presented with constant intensive low back pain on the right side for 3 years. Large doses of NSAIDs were ineffective and resulted in gastric ulcer. Magnetic resonance tomography and computed tomography imaging revealed osteoid osteoma of L3 pars interarticularis and a needle biopsy confirmed it. An innovative approach for spinal osteoid osteoma was chosen after many considerations. The patient underwent microwave ablation of the lesion in the spine.