A multicenter cohort study of spinal osteoid osteomas: results of surgical treatment and analysis of local recurrence

Nasir A Quraishi, Stefano Boriani, Silviu Sabou, Peter Pal Varga, Alessandro Luzzati, Ziya L. Gokaslan, Michael G. Fehlings, Charles G. Fisher, Mark B. Dekutoski, Laurence D. Rhines, Jeremy J. Reynolds, Niccole M. Germscheid, Chetan Bettegowda, Richard P. Williams

Research output: Contribution to journalArticle

Abstract

Background Context Spinal osteoid osteomas are benign primary tumors arising predominantly from the posterior column of the spine. These “osteoblastic” lesions have traditionally been treated with intralesional excision. Purpose The purpose of the present study was to review the treatment and local recurrence rates for symptomatic spinal osteoid osteomas. Study Design/Setting Multicenter ambispective cross-sectional observational cohort study. Patient Sample During the study period, a total of 84 patients (65 males, 19 females) were diagnosed with a spinal osteoid osteoma and received surgical treatment. The mean age at surgery was 21.8 ± 9.0 years (range: 6.7–52.4 years) and the mean follow-up was 2.7 years (13 days–14.5 years). Outcome Measures Local recurrence, perioperative morbidity, and cross-sectional survival. Methods Using the AOSpine Knowledge Forum Tumor multicenter ambispective database, surgically treated osteoid osteoma cases were identified. Patient demographic, clinical and diagnostic, treatment, local recurrence, perioperative morbidity, and cross-sectional survival data were collected and retrieved. Descriptive statistics were summarized using mean/standard deviation or frequency/percentage. Results In our study, most of the tumors were localized in the mobile spine (81 of 84 [96%]); all patients reported pain as a symptom. According to the postoperative assessment, 10 (12%) patients received an en bloc resection with marginal or wide margins, whereas two (2%) patients received en bloc resections with intralesional margins, 69 (82%) patients were treated by piecemeal “intralesional” resection, and three (4%) patients were not assessed. A total of six patients (7%) experienced a local recurrence, all of which occurred in patients who had received an intralesional resection. Conclusions Benign bone-forming tumors of the spine are uncommon. Most patients in our series underwent a piecemeal resection with intralesional margins. This remains safe with a low local recurrence rate. En bloc excision may provide more chance of complete excision of the nidus but is not mandatory. The importance of complete excision of the nidus cannot be overemphasized.

Original languageEnglish
Pages (from-to)401-408
Number of pages8
JournalSpine Journal
Volume17
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

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Keywords

  • Benign tumor
  • Cohort study
  • Primary spinal tumor
  • Recurrence
  • Spinal osteoid osteoma
  • Surgical management

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Quraishi, N. A., Boriani, S., Sabou, S., Varga, P. P., Luzzati, A., Gokaslan, Z. L., Fehlings, M. G., Fisher, C. G., Dekutoski, M. B., Rhines, L. D., Reynolds, J. J., Germscheid, N. M., Bettegowda, C., & Williams, R. P. (2017). A multicenter cohort study of spinal osteoid osteomas: results of surgical treatment and analysis of local recurrence. Spine Journal, 17(3), 401-408. https://doi.org/10.1016/j.spinee.2016.10.010