Management of osteoblastoma and osteoid osteoma of the spine in childhood

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>Osteoid osteomas and osteoblastoma of the spine are rare lesions in childhood, and management strategies have changed. The authors reviewed their recent experience with these 2 types of lesions to elucidate current treatment modalities and outcomes.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Case records and radiographic images from all cases of osteoid osteoma and osteoblastoma diagnosed between 1993 and 2008 were retrospectively reviewed, including those managed nonsurgically.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Thirty cases were identified; 22 were treated surgically and 8 were managed nonsurgically. The patients' mean age at presentation was 13 years (range 3–17 years). Of 30 patients, 29 (97%) presented with pain; 7 (23%) had scoliosis at presentation; 12 (40%) experienced relief with nonsteroidal antiinflammatory medication. Osteoid osteoma was diagnosed in 7 (32%) of the 22 patients who underwent surgery, and osteoblastoma in 15 (68%). Nine (41%) of the 22 surgically treated patients underwent fusion procedures (bone onlay or instrumentation) at the time of surgery. Pain freedom without medication had been achieved in 16 (73%) of the 22 surgically treated patients at a mean follow-up of 28 months (range 2–75 months) and was confirmed in 3 (38%) of the 8 nonsurgically treated patients at a mean follow-up of 33 months (range 24–51 months).</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Osteoid osteomas and osteoblastomas can present challenging management problems in pediatric patients. In the majority of cases in which conservative therapy fails or pathological diagnosis is required, surgery using modern intraoperative imaging and spinal instrumentation can provide symptom relief and tumor control.</jats:p></jats:sec>

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

“…Plain radiography is the most common radiological choice and is thought to have great value for diagnosing spinal OBLs [17][18][19][20]. However in our study, normal images were found in half of the patients with CO and onefourth of cases with AO, which might cause a high number of misdiagnoses if it were the only diagnostic tool used.…”

“…Although few researchers believed that subtotal excision (curettage) or resection without a wide margin was sufficient for spinal OBL because of its benign nature and limited growth, the vast majority of experts held the view that radical surgical resection was the best possible treatment [2,4,6,8,17,[24][25][26][27][28]. In our series, total excision had a much better outcome than subtotal excision ?…”

“…Some experts insisted that radiotherapy was of no benefit for spinal OBL, while others believed that it was an effective adjuvant treatment when total excision was not possible [4,8,17,24,[29][30][31][32][33][34]. We clearly found that the protocol of subtotal excision ?…”

An unusual presentation of pediatric osteoblastoma in a patient with Klippel-Trenaunay-Weber syndrome: case report

“…3,8 Ninety percent of cases occur during the first 2 decades of life, with a peak incidence between the ages of 10 and 20 years. 1,9,17 There is a male predominance (male to female ratio of 1.43-4.7:1).…”

“…1,16 These lesions are one-fourth to one-tenth as common as osteoid osteomas from which they can be difficult to differentiate clinically. 3,8 Ninety percent of cases occur during the first 2 decades of life, with a peak incidence between the ages of 10 and 20 years. 1,9,17 There is a male predominance (male to female ratio of 1.43-4.7:1).…”