title: Osteoblastomas of the spine: a comprehensive review.
abstract: Osteoblastomas are primary bone tumors with an affinity for the spine. They typically involve the posterior elements, although extension through the pedicles into the vertebral body is not uncommon. Histologically, they are usually indistinguishable from osteoid osteomas. However, there are different variants of osteoblastomas, with the more aggressive type causing more pronounced bone destruction, soft-tissue infiltration, and epidural extension. A bone scan is the most sensitive radiographic examination used to evaluate osteoblastomas. These osseous neoplasms usually present in the 2nd decade of life with dull aching pain, which is difficult to localize. At times, they can present with a painful scoliosis, which usually resolves if the osteoblastoma is resected in a timely fashion. Neurological manifestations such as radiculopathy or myelopathy do occur as well, most commonly when there is mass effect on nerve roots or the spinal cord itself. The mainstay of treatment involves surgical intervention. Curettage has been a surgical option, although marginal excision or wide en bloc resection are preferred options. Adjuvant radiotherapy and chemotherapy are generally not undertaken, although some have advocated their use after less aggressive surgical maneuvers or with residual tumor. In this manuscript, the authors have aimed to systematically review the literature and to put forth an extensive, comprehensive overview of this rare osseous tumor.
authors.affiliation: Departments of 1 Neurological Surgery and.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Galgano
authors.affiliation: Departments of 1 Neurological Surgery and.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Goulart
authors.affiliation: Pathology, Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Hans
authors.initials: H
authors.lastname: Iwenofu
authors.affiliation: Departments of 1 Neurological Surgery and.
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Chin
authors.affiliation: Orthopedics, State University of New York, Upstate Medical University, Syracuse, New York; and 
authors.forename: William
authors.initials: W
authors.lastname: Lavelle
authors.affiliation: Departments of 4 Neurological Surgery and.
authors.forename: Ehud
authors.initials: E
authors.lastname: Mendel
mesh_terms: D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D000072226:Computed Tomography Angiography / Q000379:methods; D006801:Humans; D018215:Osteoblastoma / Q000175:diagnosis* / Q000628:therapy*; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery
keywords: VA = vertebral artery; en bloc resection; neurosurgery; osteoblastoma; primary spine tumors; spine