Remodeling of the Lumbar Facet Joint After Full Endoscopic Resection for Lumbar Osteoid Osteoma: Case Report and Literature Review

Abstract

Background: Osteoid osteoma (OO) is a common benign bone tumor; however, approximately 25% of cases have spine involvement. It is often treated by image-guided radiofrequency ablation to break down the nidus. Few reports have described full endoscopic resection of the lesion, but none have described postoperative remodeling of the lumbar facet joint after surgical resection of an OO. The study aimed to describe a rare case of remodeling of the lumbar facet joint and then delineate the least invasive surgical technique of endoscopic resection of an OO.Methods: A 26-year-old man presented with severe left buttock pain and sciatica that worsened at night and was relieved by ibuprofen. Magnetic resonance imaging indicated a left inferior facet of an L3 mass-like lesion. A thin-section computed tomography image revealed a nidus, which was compatible with an OO. Full endoscopic resection was performed to completely remove the nidus of the OO.Results: At the 2-year follow-up, the patient was symptom-free and computed tomography images indicated new bone formation.Conclusions: The present case and literature review demonstrate that endoscopic resection is safe and effective for managing a posterior element of lumbar OO. Furthermore, this technique allows complete removal of the nidus with minimal damage to surrounding structures and leads to remodeling of the resection site.Clinical Relevance: Patients with OO involving the posterior element of the spine can present with buttock and radicular pain, mimicking lumbar disc herniation. OO can be successfully removed by the full endoscopic method and remodeling of the resected site can be anticipated.Level of Evidence: 4.

Osteoid osteoma presenting with scoliosis: successful resection with endoscopic excision

“…Using endoscopic surgery for spinal OO excision has been shown to minimise the associated morbidity when compared with other surgical techniques. Following an exhaustive literature search focused on studies detailing endoscopic excision of OO, we identified nine relevant studies18–26 (table 1). The collective findings from these studies, spanning the cervical, thoracic and lumbar spine, consistently showcase successful outcomes accompanied by minimal complication rates (table 1).…”

Full Endoscopy Combined with Allogeneic Bone Grafting for Benign Spinal Lesions: Technical Notes and Preliminary Clinical Results

“…In 2020, Xie et al reported 11 cases of symptomatic benign spinal lesions of the lumbar and sacral spine treated with full spinal endoscopy, and all patients showed symptomatic relief with no recurrence during 1-3 years of follow-up [17]. In 2022, Kotheeranurak et al reported treatment of a case of osteoid osteoma of the L3 vertebral body with no recurrence at 2 years follow-up [18].…”

Remodeling of Lumbar Spinal Osteoid Osteoma Resected With Microscopic Surgery in a 15-Year-Old Basketball Player: A Case Report

“…Hikata et al reported a case of cervical spinal OO treated with microendoscopic resection and demonstrated remodeling in the resected site at one year postoperative CT [ 17 ]. Kotheeranurak et al presented a lumbar spinal OO treated with endoscopic resection, showing remodeling of the lumbar facet joint at two years postoperative CT [ 18 ]. These suggested that bone remodeling can be expected within one to two years after endoscopic and microscopic, less invasive surgery of the spinal OO.…”