• Nasir A Quraishi, Stefano Boriani, Silviu Sabou, Peter P 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, and Richard P Williams.
• Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, UK. Electronic address: nasquraishi@hotmail.com.
• Spine J. 2017 Mar 1; 17 (3): 401-408.

Background ContextSpinal 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.PurposeThe purpose of the present study was to review the treatment and local recurrence rates for symptomatic spinal osteoid osteomas.Study Design/SettingMulticenter ambispective cross-sectional observational cohort study.Patient SampleDuring 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 MeasuresLocal recurrence, perioperative morbidity, and cross-sectional survival.MethodsUsing 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.ResultsIn 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.ConclusionsBenign 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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