Microendoscopic Excision of Osteoid Osteoma in the Pedicle of the Third Lumbar Vertebra

Osteoid osteoma presenting with scoliosis: successful resection with endoscopic excision

A young male in his mid-teen years presented with severe back pain for 3 months and was subsequently diagnosed with osteoid osteoma in the left superior articular process of the L4 vertebra. Initial treatment with non-steroidal anti-inflammatory drugs provided temporary relief. Due to concerns about scoliosis progression along with unrelieved pain, a multidisciplinary team recommended endoscopic excision of the osteoid osteoma. The procedure resulted in complete pain relief and an improvement in the scoliosis curve from 22° of Cobb's angle to 12 degrees at the 8-month follow-up.

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

This case report focuses on a 15-year-old competitive-level high school basketball player who experienced chronic low back pain. Diagnostic imaging revealed osteoid osteoma in the L5 posterior element, causing osteosclerotic deformity of the left lamina and more inferior facet. To return him to the condition of sports activity, less invasive surgery of microscopic tumor resection with autologous bone grafting was planned instead of CT-guided ablation, which can cause thermal injury to nearby tissues. This procedure could preserve spinal structures, including the facet, pedicle, and paravertebral muscles. The day after surgery, the patient experienced a complete resolution of lower back pain. He gradually resumed light exercise two months postoperatively. Three-month follow-up CT imaging revealed bone remodeling at the resection site, to return to complete basketball activities. Over five years, no tumor recurrence or symptoms were observed, and he maintained his competitive activity level.

Complete Endoscopic Resection of an Osteoid Osteoma in the Body of a Thoracic Vertebra: A Case Report

CASE

A 29-year-old man presented nontraumatic diffuse thoracic pain. Magnetic resonance imaging of the spine showed a cortical lesion with peripheral hyperintensity, a central sclerotic hypointense nidus, and surrounding paraspinal inflammatory changes at the T3 vertebral body. Clinical and radiologic findings were consistent with an osteoid osteoma. The patient successfully underwent an endoscopic partial corpectomy and mass resection. At the 6-month follow-up, radiographs showed complete tumor resolution.

CONCLUSION

Endoscopic resection is an adequate and minimally invasive technique for the complete resection of osteoid osteomas.

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

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

Full-Endoscopic Resection of Osteoid Osteoma in the Thoracic Spine: A Case Report

Common symptoms such as axial pain or nocturnal pain, associated with warning signs that are often worrisome in addition to nonspecific radiological findings, can characterize benign lesions in the spine, and osteoid osteoma is among them. We describe here a clinical case of a pediatric patient with an expansive bone lesion in the thoracic spine discovered after investigation for thoracic pain, mainly at night, which, despite a good response to simple analgesics, evolved in the short term with global spinal deformity. After a multidisciplinary evaluation, she underwent surgical resection using a pioneering endoscopic technique that allowed the definitive anatomopathological diagnosis of osteoid osteoma and guaranteeing very satisfactory treatment and evolution. Although there are already several therapeutic techniques described and with good results in specific cases of osteoid osteomas and other benign neoplastic lesions of the spine, full-endoscopic resection appears as an innovative and potentially promising option for diagnosis and treatment, especially since it is a safe, effective, and not too morbid intervention.

Osteoid osteoma: lower back pain combined with scoliosis

Osteoid osteoma is a small benign bone tumor that is primarily localized in long bone; lumbar osteoid osteoma combined with scoliosis has rarely been reported. Here, we describe a 9-year-old boy who complained of back pain and scoliosis. He underwent nidus resection and did not experience complications or osteoid osteoma recurrence. His pain and scoliosis were relieved after the operation. The findings in this case indicate that resection of osteoid osteoma is an effective and safe method of treatment. The lumbar spine is the most common location of osteoid osteoma, which causes painful scoliosis. Nidus resection can provide relief of back pain and scoliosis.

Pseudo-ataxia due to Osteoid Osteoma

Background

Ataxia is diagnosed by typical features on examination suggestive of a cerebellar etiology and can invoke extensive diagnostic testing. Osteoid osteomas (OOs) are benign bone tumors of the lower limbs that occasionally present with focal neurological signs.

Case Report

A 3-year-old male presented with apparent progressive gait ataxia and non-specific leg pain. Initial imaging was unremarkable. However, 12 months later, a lesion was identified in the distal right femur, which was found to be an OO. The gait disorder and pain resolved after surgery.

Discussion

This case highlights the challenges of diagnosing a gait disorder in young children.