title: A multicenter cohort study of spinal osteoid osteomas: results of surgical treatment and analysis of local recurrence.
abstract: Spinal 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.
  
  
  
  The purpose of the present study was to review the treatment and local recurrence rates for symptomatic spinal osteoid osteomas.
  
  
  
  Multicenter ambispective cross-sectional observational cohort study.
  
  
  
  During 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).
  
  
  
  Local recurrence, perioperative morbidity, and cross-sectional survival.
  
  
  
  Using 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.
  
  
  
  In 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.
  
  
  
  Benign 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.
authors.affiliation: 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.
authors.forename: Nasir A
authors.initials: NA
authors.lastname: Quraishi
authors.affiliation: Department of Oncologic and Degenerative Spine Surgery, Rizzoli Institute, via G.C.Pupilli, 1 - 40136 Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Boriani
authors.affiliation: Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Silviu
authors.initials: S
authors.lastname: Sabou
authors.affiliation: The National Center for Spinal Disorders Budapest, Királyhágó u. 1, 1126, Hungary.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Varga
authors.affiliation: Centro di Chirurgia Ortopedica Oncologica e Ricostruttiva del Rachide Istituto Orthopedico Galeazzi, Via Riccardo Galeazzi, 4, 20161 Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Luzzati
authors.affiliation: Department of Neurosurgery, The Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI 02903, USA.
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.affiliation: Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst St, Toronto, ON M5T 2S8, Canada.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
authors.affiliation: Combined Neurosurgery and Orthopaedic Spine Program, Blusson Spinal Cord Centre, University of British Columbia, 6th Floor, 818 West 10th Avenue, Vancouver, British Columbia V5Z 1M9, Canada.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Fisher
authors.affiliation: Department of Orthopaedic Surgery, The CORE Institute, 14520 W Granite Valley Dr #210, Sun City West, AZ 85375, USA.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Dekutoski
authors.affiliation: Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 442, Houston, TX 77030, USA.
authors.forename: Laurence D
authors.initials: LD
authors.lastname: Rhines
authors.affiliation: Spinal Division, Nuffield Orthopedic Centre, University of Oxford, Windmill Road, Headington, Oxford OX3 7HE, UK.
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Reynolds
authors.affiliation: Research Department, AOSpine International, Clavadelerstrasse, 87270 Davos Platz, Switzerland.
authors.forename: Niccole M
authors.initials: NM
authors.lastname: Germscheid
authors.affiliation: Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA.
authors.forename: Chetan
authors.initials: C
authors.lastname: Bettegowda
authors.affiliation: Princess Alexandra Hospital, 237 Ipswich Rd, Woolloongabba, QLD 4102, Australia.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Benign tumor; Cohort study; Primary spinal tumor; Recurrence; Spinal osteoid osteoma; Surgical management