title: Management Strategy of Osteoblastomas Localized in the Occipitocervical Junction.
abstract: OBJECTIVE
  The aim of this article was to analyze extracted patient data from the literature and highlight the best treatment options and survival outcomes for osteoblastomas in the occipitocervical region.
  
  
  METHODS
  A systematic literature search method was used to select articles containing information about the demographic features, tumor location, treatment characteristics, adjuvant therapies, and follow-up time.
  
  
  RESULTS
  From 25 articles, 31 cases of osteoblastoma in the occipitocervical junction were selected for analysis. Average patient age was 17 years (range, 5-57 years); there were 21 male (67%) and 10 female (33%) patients. All patients had cervical pain as the presenting symptom. Other symptoms included torticollis (0.13%) and sensory or motor neurologic deficits (0.16%). The average follow-up time was 41 months, and the local recurrence rate was 0.125%. Recommendations of each article are categorized and discussed in detail.
  
  
  CONCLUSIONS
  Osteoblastoma is a rare entity in the occipitocervical region, so treatment experiences are limited and mostly based on case reports. To determine the best treatment for these lesions, osteoblastomas should be staged using the Enneking staging system; different methods may be recommended for different stages, and the feasibility of fusion depends on the remaining amount of bony structures and joints. Additional adjuvant therapies may be recommended only in special cases.
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary; Department of Neurosurgery, Semmelweis University, Budapest, Hungary. Electronic address: gczigleczki@gmail.com.
authors.forename: Gábor
authors.initials: G
authors.lastname: Czigléczki
authors.affiliation: Department of Neurosurgery, Semmelweis University, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Nagy
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Papp
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary.
authors.forename: Csaba
authors.initials: C
authors.lastname: Padányi
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary; Department of Neurosurgery, Semmelweis University, Budapest, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Banczerowski
mesh_terms: D000293:Adolescent; D000328:Adult; D001268:Atlanto-Axial Joint / Q000601:surgery*; D015984:Causality; D002574:Cervical Vertebrae / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000401:mortality* / Q000517:prevention & control; D018215:Osteoblastoma / Q000401:mortality* / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors; D013118:Spinal Cord Diseases / Q000401:mortality* / Q000517:prevention & control; D013125:Spinal Neoplasms / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adjuvant radiotherapy and chemotherapy; Cervical osteoblastoma; En bloc resection; Enneking system; Occipitocervical fixation; Occipitocervical region