Navigation-Assisted Endoscopic Excision of Lumbar Vertebral Osteoid Osteoma: A Case Report

Osteoid osteoma is a benign osteogenic tumor that commonly affects young individuals and may involve the posterior elements of the spine. Surgical intervention is indicated when conservative management fails. We describe a novel technique of navigation-assisted endoscopic excision for the precise and minimally invasive management of lumbar vertebral osteoid osteoma.

A 21-year-old male presented with nocturnal low back pain for 6 months, partially relieved with non-steroidal anti-inflammatory drugs. Computed tomography revealed a well-defined nidus involving the left lamina of the L2 vertebra in close proximity to neural structures. Navigation-assisted endoscopic excision of the lesion was performed.

Using a 3D C-arm-based navigation system, precise localization and trajectory planning were achieved. Complete en bloc excision of the nidus was performed endoscopically with preservation of surrounding bony and neural structures. The patient experienced immediate post-operative pain relief and was discharged on post-operative day 1. Histopathology confirmed osteoid osteoma, and no recurrence was noted at 15-month follow-up.

Navigation-assisted endoscopic excision offers a safe, effective, and minimally invasive alternative for spinal osteoid osteoma, allowing precise localization, reduced morbidity, and histological confirmation.