Surgical Management of Osteoblastoma of the Spine:Case Series and Review of the Literature

AIm: To describe the demographics, clinical and radiologic presentation, surgical considerations, and clinical outcomes associated with spinal osteoblastoma.Mater Ial and Methods: A spinal tumor database of 522 patients treated surgically at a single institution between January2002 and June 2012 was analyzed and five patients with spinal osteoblastoma were identified and included in this study. Basicdemographic and epidemiological data were recorded. Tumor characteristics, surgical parameters, and clinical follow-up data werenoted.Results: The mean follow-up was 21.9 months. There were four males and one female, and the mean age at diagnosis was28.4 years. There was a mean reported symptom length of 26.4 months prior to diagnosis. There were three cervical lesions, onelumbar lesion, and one sacrococcygeal lesion. One patient was Enneking stage III and four patients were Enneking stage II. Basedon spinal instability neoplastic score criteria, two patients were stable and three patients were potentially unstable. Four patientshad intralesional gross total resections and one patient had an en bloc marginal resection. All patients remained neurologicallystable or improved postoperatively. A single patient had recurrence of a previously resected osteoid osteoma with progression toosteoblastoma.ConclusIon: Aggressive surgical resection of spinal osteoblastoma is suggested to minimize the risk of tumor recurrence,although this may still occur even with en bloc resection. Patients rarely present with preoperative spinal instability, but surgicalfusion is often required due to removal of structural elements of the spine during resection. Of note, osteoid osteoma may progressto osteoblastoma in the spine despite prior resection