title: Surgical treatment options for aggressive osteoblastoma in the mobile spine.
abstract: OBJECTIVE
  Osteoblastoma (OBL) is a benign bone tumor with considerable recurrence potential. Resection is the mainstay for the treatment of Enneking stage 3 (st. 3) OBL. This retrospective study aimed to verify the appropriate surgical strategy for st. 3 lesions in the mobile spine.
  
  
  METHODS
  19 cases of st. 3 OBL was diagnosed between 2001 and 2011. Clinical, radiological, surgical, and follow-up data were analyzed. This series included 14 men and 5 women and the mean age at diagnosis was 30.4 years. The lesions were located in the cervical spine in ten cases, in the thoracic spine in eight, and in the lumbar spine in one. Fourteen patients were surgically treated for the first time (intact cases), and five were referred to us after previous unsuccessful treatments (non-intact cases).
  
  
  RESULTS
  Before 2008, 11 patients underwent curettage followed by radiotherapy, including 5 non-intact cases and 6 intact cases. Tumor recurrence was observed in all five non-intact cases and four of the six intact cases. After 2008, eight intact patients underwent intralesional vertebrectomy, including six who underwent piecemeal total vertebrectomy and two who underwent intralesional en bloc vertebrectomy. All the eight patients had embolization before surgery. 18 patients had an average 67.3 months (range 36-148 months) of follow-up. Recurrence was not observed in any of these eight cases with intralesional vertebrectomy.
  
  
  CONCLUSIONS
  Intralesional total vertebrectomy might be an appropriate choice for intact st. 3 OBL spine lesions. More cases with longer follow-up periods should be recruited in the future to better understand the treatment options available for this disease.
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, No 49. North Garden Road, HaiDian District, 100191, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Jiang
authors.forename: Xiao Guang
authors.initials: XG
authors.lastname: Liu
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.forename: Shao Min
authors.initials: SM
authors.lastname: Yang
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Wei
authors.forename: Feng Liang
authors.initials: FL
authors.lastname: Wu
authors.forename: Hua
authors.initials: H
authors.lastname: Zhou
authors.forename: Lei
authors.initials: L
authors.lastname: Dang
authors.forename: Zhong Jun
authors.initials: ZJ
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D003475:Curettage; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018215:Osteoblastoma / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
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