Spinal osteoid osteoma in the pediatric population: A management algorithm and systematic review

Area of Science:

• Pediatric Orthopedics
• Neurosurgery
• Oncology

Background:

• Osteoid osteomas (OOs) are benign bone tumors that can occur in the pediatric spine.
• Management of spinal OOs in children requires a structured approach due to potential complications like scoliosis and radicular pain.

Purpose of the Study:

• To develop an accessible, step-wise management algorithm for pediatric spinal osteoid osteomas (OOs).
• To synthesize evidence from published literature on diagnostic evaluation, treatment strategies, and outcomes for pediatric spinal OOs.

Main Methods:

• A systematic review of English-language studies on PubMed was conducted.
• Data extraction focused on clinical presentation, diagnostic and imaging modalities, management strategies, and treatment outcomes.
• Ten studies involving 85 pediatric patients with spinal OOs were included.

Main Results:

• Back pain, scoliosis, and radicular pain were common presenting symptoms.
• Diagnostic tools included radiographs, CT, MRI, bone scans, and frozen section.
• Treatment options ranged from conservative management to surgical resection and percutaneous image-guided procedures, with most patients experiencing pain resolution.

Conclusions:

• A step-wise approach is recommended for managing pediatric spinal osteoid osteomas.
• The proposed algorithm provides a framework based on current evidence (levels 3-4) for clinical decision-making.