Clinical findings and results of surgical resection of thoracolumbar osteoid osteoma

Abstract

Study design: Descriptive, cases series study.

Purpose: To evaluate clinical findings and results of treatment of patients with spinal osteoid osteoma who underwent surgery.

Overview of literature: Osteoid osteoma is a benign tumor with spinal involvement rate of about 10%. It is manifested during adolescence with symptoms such as painful scoliosis. To treat the problem, operation on the patients and excising the nidus are suggested.

Methods: This descriptive study was conducted on 11 patients with spinal osteoid osteoma at our orthopedic educational center. All patients were treated through open surgery and nidus curettage. All samples were pathologically confirmed. Imaging methods (spiral computed tomography-scan) was used in preoperative planning. Scoliosis and other clinical findings were studied.

Results: The study was conducted on 11 patients comprising 6 females (54.5%) and 5 males (45.5%) with the mean age of 14.6 years. Mean deviation of scoliosis resulting from spinal osteoid osteoma was 22.8 degrees. There was more scoliosis in the involvement of the lumbar vertebra. In comparison with adults, scoliosis was more severe in youths. There was one case of vertebra body involvement with manifestation of painful scoliosis. Due to lack of careful preoperative examination, the surgery was repeated for this case. No sign of recurrence was observed in patients who underwent open surgery and all scoliosis in the follow-up had improved.

Conclusions: Based on our findings, surgical excision of spinal ostoeid osteoma was successful and complete recovery was achieved in spinal deformity in the course of follow-up. Scoliosis is often seen during adolescence and lumbar involvement is more severe.

Keywords: Osteoid osteoma; Review; Scoliosis; Spinal deformity.

Fig. 1

(A) Macroscopic view of nidus. (B) Microscopic appearance used H&E stain technique showed woven bone.

Fig. 2

(A) Involvement of posterior part (arrow) of vertebra. (B) Twenty degrees scoliosis deviation in thoracolumbar spine.

Fig. 3

(A) Involvement of body of T12 vertebra with painful scoliosis in an 8-year-old boy. (B) Twenty-one degrees spinal deviation due to T12 osteoid osteoma.

Fig. 4

(A) Clinical photo of spinal deformity. (B) Axial computed tomography of vertebra indicating posterior lesion. (C) Radiography showed 30° scoliosis in a 15-year-old girl.

Fig. 5

(A) Radiography of spine 9 months after treatment. (B) Clinical photo of patient with 20° spinal deviation that was resolved in follow-up.