Osteoid Osteoma and Osteoblastoma of the Spine.
10.4184/jkss.2003.10.1.46
- Author:
Jeong Hyun HA
1
;
Young Joon AHN
;
Jae Hyup LEE
;
Jae Hag LEE
;
Ru Ppo PARK
;
Bong Soon CHANG
;
Young Min KIM
;
Sang Cheol SEONG
;
Hee Joong KIM
;
Choon Ki LEE
Author Information
1. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea. bschang@medicine.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Spine;
Osteoid osteoma;
Osteoblastoma;
Scoliosis;
Torticollis;
MRI
- MeSH:
Adult;
Communicable Diseases;
Congenital Abnormalities;
Diagnosis;
Diagnosis, Differential;
Diagnostic Errors;
Follow-Up Studies;
Humans;
Magnetic Resonance Imaging;
Osteoblastoma*;
Osteoma, Osteoid*;
Physical Examination;
Recurrence;
Retrospective Studies;
Scoliosis;
Spine*;
Tomography, X-Ray Computed;
Torticollis;
Transplants
- From:Journal of Korean Society of Spine Surgery
2003;10(1):46-54
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A retrospective study OBJECTIVE: To analyze the clinical and radiological findings, and the results of the surgical treatment of osteoid osteomas and osteoblastomas of the spine. SUMMARY OF LITERATURE REVIEW: With the development of new imaging techniques, earlier diagnoses have been reported. However, a few reports of unexpected misdiagnosis, and postoperative results, have also been published. MATERIALS AND METHODS: Between January 1980 and September 2002, twelve patients were diagnosed with an osteoid osteoma or osteoblastoma of the spine, and were surgically treated. The average preoperative symptom-duration and follow-up period were 20 and 33 months, with ranges from 6weeks to 96 months, and 4 to 120 months, respectively. All the patients were younger than 30 years old, with the majority being of growing age, and underwent at least a bone scan, CT or MRI, as part of the diagnostic procedures. RESULTS: The most common symptom was pain at the lesion, with 2 torticollis and 4 scoliosis observed as combined spine deformities, respectively. Neurological abnormalities were seen more often in the osteoblastomas (80%) than in the osteoid osteomas (43%). From the radiological findings, a CT scan was a more effective procedure than any of the other diagnostic modalities in differentiating an osteosclerotic bony lesion and a nidus. In three out of the five MRI, 2 cases were misdiagnosed as infections and the other as a malignant tumor, with no significant abnormal findings in the simple roentgenogram. A wide excision was performed in all patients, and a fusion, with a bone graft, was also performed in 8. There were no postoperative spinal instabilities or complications. CONCLUSION: In a differential diagnosis, careful history taking for pain, and a physical examination for spine deformity, are required. Without any clinical information, these tumors can be misdiagnosed as malignant tumors, or other infectious diseases, in a MRI. With regard to the surgical treatment, there were no cases of recurrence reported due to the wide excision, but a fusion, both with or without instrumentation, can be considered to prevent postoperative spine instability.
