Osteoid osteomas: intraoperative bone scan-assisted resection. Clinical article.
OBJECTIVE
Osteoid osteomas (OOs) are benign lesions of the spine, but can cause significant pain and spinal deformity in the pediatric population. They are often surgically elusive, and may require multiple surgical procedures to ensure complete resection. Nuclear medicine intraoperative bone scans (IOBSs) are highly sensitive for lesion localization and verification of complete surgical extirpation.


METHODS
A retrospective review of 20 consecutive patients who had undergone resection of a spinal OO at the authors' institution was undertaken. In all cases, IOBSs were used for lesion localization and verification of resection. Postoperative imaging and clinical follow-up were obtained.


RESULTS
The average length of follow-up was 56 months, with a range of 8-156 months. Five patients had undergone a total of 12 unsuccessful prior procedures for resection at other institutions where IOBSs were not used. In these patients, complete resection was accomplished with the use of IOBSs at the authors' institution. Of the 15 patients who presented to this institution with a newly diagnosed OO and who underwent IOBS-assisted resection, 14 had complete resection without recurrence. One patient, however, was found to have a discrete recurrence adjacent to the initial resection bed at the time of follow-up.


CONCLUSIONS
Osteoid osteomas are benign lesions of the spine, and complete resection is curative. If resection is incomplete, then recurrence is likely. The IOBS modality is highly sensitive for detecting OO and for guiding complete resection. The IOBS modality should be considered as a first-line surgical adjunct in cases of suspected OO.
Blaskiewicz
Donald J
DJ
Department of Neurological Surgery, State University of New York Upstate Medical University, Syracuse, New York, NY, USA.
Sure
Durga R
DR
Hedequist
Daniel J
DJ
Emans
John B
JB
Grant
Frederick
F
Proctor
Mark R
MR
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D011829:Radiation Dosage; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome