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Osteoid Osteoma of the Mobile Spine: Surgical Outcomes in 81 Patients

Gasbarrini, Alessandro MD*; Cappuccio, Michele MD; Bandiera, Stefano MD*; Amendola, Luca MD*; van Urk, Paul MD; Boriani, Stefano MD*

doi: 10.1097/BRS.0b013e3181ffeb5e
Surgery

Study Design. A restrospective review of 81 cases of osteoid osteoma of the mobile spine submitted to surgical treatment.

Objective. Analyze pro and contras of different techniques (conventional and minimally invasive) for the treatment of osteoid osteoma.

Summary of Background Data. Intralesional excision has been considered the standard treatment for spinal osteoid osteoma. The high success rate of minimally invasive surgery in the treatment of a variety of spinal disorders lead us to believe this technique can also be applicable for the treatment of osteoid osteoma of the spine.

Methods. Eighty-one patients affected by osteoid osteoma were consecutively treated by the same team with intralesional excision using conventional or minimally invasive approach by video-assisted endoscopy, microscope, or percutaneous radiofrequency coagulation. The clinical features, the radiologic findings, and the outcome were reviewed. Pain and neurologic symptoms, were scored before surgery, after surgery and at the follow-up. Complications and local recurrences were also recorded.

Results. Immediate relief of pain was observed after surgery in all patients. One patient showed mild neurologic impairment before treatment but became free of neurologic symptoms postoperative. Five local recurrences were found in four patients, always associated with pain. Three of these patients underwent surgery for a second time and one patient for a third time. There were two complications because surgery in two patients. One patient developed a pneumothorax, the other a hematoma. No related cases of kyphosis or scoliosis surgery were observed.

Conclusion. Conventional excision therapy is a effective and reliable treatment for osteoid osteoma associated to low morbidity and low local recurrence rate. Minimally invasive surgery is emerging as an alternative method, reducing soft tissue trauma and the collateral damage caused by traditional surgical approach, allow patients a more rapid and complete return to normal function.

A review of 81 cases of spinal osteoid osteoma treated by conventional or minimally invasive approach is presented. All patients experienced immediate relief of pain after surgery or became pain free after the treatment of five local recurrences. The majority of patients have been approached with conventional excision surgery, a really effective and safe treatment, associated with a low local recurrence and complication rate. Mini-invasive surgery is emerging as an alternative and reliable method for osteoid osteoma treatment.

*Department of Oncologic and Degenerative Spine Surgery, Rizzoli Institute, Bologna, Italy

Department of Orthopedics and Traumatology, Maggiore Hospital, Bologna, Italy

Department of Orthopaedic Surgery, Free University Hospital, Amsterdam, Netherlands.

Address correspondence and reprint requests to Luca Amendola, MD, Department of Oncologic and Degenerative Spine Surgery, Rizzoli Institute, Via Pupilli 1 Bologna, Italy; E-mail: luca.amendola@yahoo.it.

Acknowledgment date: March 19, 2010; First Revision date: September 5, 2010; Acceptance date: October 1, 2010.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2011 Lippincott Williams & Wilkins, Inc.