CLINICAL MANIFESTATION AND STRATEGY FOR SURGICAL RESECTION AND RECONSTRUCTION OF THORACOLUMBAR VERTEBRAL OSTEOID OSTEOMA_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHI Xin , REN Ke , WU Sujia , ZHOU Guangxin , LI Chengjun , LU Meng , ZHAO Jianning.

Department of Orthopedics, Nanjing General Hospital of Nanjing Military Command Region, Nanjing Jiangsu, 210002, P.R.China.;

Corresponding author：

Keywords：

Osteoid osteoma; Thoracolumbar vertebrae; Diagnosis; Surgical treatment

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【Abstract】 Objective To investigate the clinical manifestation of thoracolumbar vertebral osteoid osteoma and to evaluate the surgical procedure and effectiveness of transpedicular tumor resection and spine reconstruction with posterior pedicle screw system and bone graft. Methods Between January 2001 and June 2010, 8 cases of thoracolumbar vertebral osteoid osteoma underwent one-stage transpedicular intralesional excision and bone graft combined with spine reconstruction with pedicle screw system through posterior approach. There were 5 males and 3 females with a median age of 15.5 years (range, 6-27 years). Affected segments included T8 in 1 case, T10 in 1 case, L2 in 2 cases, L3 in 1 case, L4 in 1 case, and L5 in 2 cases. All of the cases had back pain, 1 had radiating pain of lower extremity, and 4 patients presented with scoliosis. The mean diameter of lesions was 1.6 cm (range, 0.9-2.0 cm). Results The mean operation time was 110 minutes (range, 70-170 minutes) and the mean blood loss was 720 mL (range, 300-1 400 mL). The postoperative pathologic examination showed osteoid osteoma in all cases. All patients achieved healing of the incisions by first intention. Immediate relief of pain was observed after operation in all patients without complication. The patients were followed up 12-58 months (mean, 39 months). No local recurrence or spinal deformity was observed during the follow-up. Conclusion CT can show a low attenuation nidus with central mineralization and varying degrees of perinidal sclerosis, so it has great value for final diagnosis of thoracolumbar vertebral osteoid osteoma. One-stage transpedicular intralesional excision supplemented by impaction bone graft and combined posterior pedicle screw stabilization is a safe and effective treatment.

Citation： SHI Xin,REN Ke,WU Sujia,ZHOU Guangxin,LI Chengjun,LU Meng,ZHAO Jianning.. CLINICAL MANIFESTATION AND STRATEGY FOR SURGICAL RESECTION AND RECONSTRUCTION OF THORACOLUMBAR VERTEBRAL OSTEOID OSTEOMA. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(1): 78-82. doi: Copy

1.	system. Jpn J Radiol, 2011, 29(2): 138-143.
2.	osteoid osteoma with conservative management: imaging correlation.
3.	Skeletal Radiol, 2007, 36 Suppl 1: S72-S76.
4.	ablation of spinal osteoid osteoma: clinical outcome. Spine (Phila Pa 1976), 2009, 34(9): 901-904.
5.	and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng, 2011, 133(7): 071010.
6.	CT guidance. Surg Neurol Int, 2011, 2: 31.
7.	lumbar spine segment: a finite element analysis study. Biomed Mater Eng, 2010, 20(6): 349-359.
8.	Gasbarrini A, Cappuccio M, Bandiera S, et al. Osteoid osteoma of the mobile spine: surgical outcomes in 81 patients. Spine (Phila Pa 1976), 2011, 36(24): 2089-2093.
9.	Miyazaki M, Aoki J, Miyazaki A, et al. Percutaneous radiofrequency ablation of osteoid osteoma using cool-tip electrodes without the cooling.
10.	Burn SC, Ansorge O, Zeller R, et al. Management of osteoblastoma and osteoid osteoma of the spine in childhood. J Neurosurg Pediatr, 2009, 4(5): 434-438.
11.	Jayakumar P, Harish S, Nnadi C, et al. Symptomatic resolution of spinal.
12.	Vanderschueren GM, Taminiau AH, Obermann WR, et al. Osteoid osteoma: clinical results with thermocoagulation. Radiology, 2002, 224(1): 82-86.
13.	Vanderschueren GM, Obermann WR, Dijkstra SP, et al. Radiofrequency.
14.	Peyser AB, Makley JT, Callewart CC, et al. Osteoma of the long bones and the spine. A study of eleven patients and a review of the literature. J Bone Joint Surg (Am), 1996, 78(8): 1172-1180.
15.	Matsumura A, Namikawa T, Terai H, et al. The influence of approach side on facet preservation in microscopic bilateral decompression via a unilateral approach for degenerative lumbar scoliosis. Clinical article. J Neurosurg Spine, 2010, 13(6): 758-765.
16.	Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics.
17.	Thorat JD, Rajendra T, Thirugnanam A, et al. Single-stage posterior midline approach for dumbbell tumors of the thoracic spine, with intraoperative.
18.	Tian NF, Xu HZ, Wang XY, et al. Morphometric comparisons between the pedicle and the pedicle rib unit in the immature Chinese thoracic spine: a computed tomographic assessment. Spine (Phila Pa 1976), 2010, 35(16): 1514-1519.
19.	Zindrick MR, Knight GW, Sartori MJ, et al. Pedicle morphology of the immature thoracolumbar spine. Spine (Phila Pa 1976), 2000, 25(21): 2726-2735.
20.	陈立言, 彭新生, 李佛保, 等. 椎弓根钉固定在10岁以下小儿胸腰椎疾患治疗中的应用. 中国脊柱脊髓杂志, 2006, 16(4): 263-266.
21.	Li Y, Lewis G. Influence of loading cycle profile and frequency on a biomechanical parameter of a model of a balloon kyphoplasty-augmented.
22.	Jain S, Modi HN, Suh SW, et al. Pedicle shifting or migration as one of the causes of curve progression after posterior fusion: an interesting case report and review of literature. J Pediatr Orthop B, 2009, 18(6): 369-374.
23.	Kawahara C, Tanaka Y, Kato H, et al. Myolysis of the erector spinae muscles as the cause of scoliosis in osteoid osteoma of the spine. Spine (Phila Pa 1976), 2002, 27(12): E313-315.

1. system. Jpn J Radiol, 2011, 29(2): 138-143.
2. osteoid osteoma with conservative management: imaging correlation.
3. Skeletal Radiol, 2007, 36 Suppl 1: S72-S76.
4. ablation of spinal osteoid osteoma: clinical outcome. Spine (Phila Pa 1976), 2009, 34(9): 901-904.
5. and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng, 2011, 133(7): 071010.
6. CT guidance. Surg Neurol Int, 2011, 2: 31.
7. lumbar spine segment: a finite element analysis study. Biomed Mater Eng, 2010, 20(6): 349-359.
8. Gasbarrini A, Cappuccio M, Bandiera S, et al. Osteoid osteoma of the mobile spine: surgical outcomes in 81 patients. Spine (Phila Pa 1976), 2011, 36(24): 2089-2093.
9. Miyazaki M, Aoki J, Miyazaki A, et al. Percutaneous radiofrequency ablation of osteoid osteoma using cool-tip electrodes without the cooling.
10. Burn SC, Ansorge O, Zeller R, et al. Management of osteoblastoma and osteoid osteoma of the spine in childhood. J Neurosurg Pediatr, 2009, 4(5): 434-438.
11. Jayakumar P, Harish S, Nnadi C, et al. Symptomatic resolution of spinal.
12. Vanderschueren GM, Taminiau AH, Obermann WR, et al. Osteoid osteoma: clinical results with thermocoagulation. Radiology, 2002, 224(1): 82-86.
13. Vanderschueren GM, Obermann WR, Dijkstra SP, et al. Radiofrequency.
14. Peyser AB, Makley JT, Callewart CC, et al. Osteoma of the long bones and the spine. A study of eleven patients and a review of the literature. J Bone Joint Surg (Am), 1996, 78(8): 1172-1180.
15. Matsumura A, Namikawa T, Terai H, et al. The influence of approach side on facet preservation in microscopic bilateral decompression via a unilateral approach for degenerative lumbar scoliosis. Clinical article. J Neurosurg Spine, 2010, 13(6): 758-765.
16. Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics.
17. Thorat JD, Rajendra T, Thirugnanam A, et al. Single-stage posterior midline approach for dumbbell tumors of the thoracic spine, with intraoperative.
18. Tian NF, Xu HZ, Wang XY, et al. Morphometric comparisons between the pedicle and the pedicle rib unit in the immature Chinese thoracic spine: a computed tomographic assessment. Spine (Phila Pa 1976), 2010, 35(16): 1514-1519.
19. Zindrick MR, Knight GW, Sartori MJ, et al. Pedicle morphology of the immature thoracolumbar spine. Spine (Phila Pa 1976), 2000, 25(21): 2726-2735.
20. 陈立言, 彭新生, 李佛保, 等. 椎弓根钉固定在10岁以下小儿胸腰椎疾患治疗中的应用. 中国脊柱脊髓杂志, 2006, 16(4): 263-266.
21. Li Y, Lewis G. Influence of loading cycle profile and frequency on a biomechanical parameter of a model of a balloon kyphoplasty-augmented.
22. Jain S, Modi HN, Suh SW, et al. Pedicle shifting or migration as one of the causes of curve progression after posterior fusion: an interesting case report and review of literature. J Pediatr Orthop B, 2009, 18(6): 369-374.
23. Kawahara C, Tanaka Y, Kato H, et al. Myolysis of the erector spinae muscles as the cause of scoliosis in osteoid osteoma of the spine. Spine (Phila Pa 1976), 2002, 27(12): E313-315.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL MANIFESTATION AND STRATEGY FOR SURGICAL RESECTION AND RECONSTRUCTION OF THORACOLUMBAR VERTEBRAL OSTEOID OSTEOMA

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