Balancing safe resection and spinal stability in osteoblastoma and osteoid osteoma: a retrospective study

To report the clinical, functional and oncological outcome in patients with spinal OBL/OO (osteoblastoma/osteoid osteoma) using Enneking and WBB staging system treated at a single center.

This is a retrospective observational study in which the hospital records of 20 patients with OBL and 11 patients with OO were reviewed with a minimum follow-up period of 24 months. Besides demographic information, presenting symptoms, radiological findings and operative details, the outcome measures reported were: neurological (ASIA) and non-neurological complications, patient-reported outcome score (visual analogue scale) and local recurrence after surgery.

The mean age at presentation was 20.2 ± 9.2 years and 17.3 ± 6.8 years, respectively for the OBL and OO patient groups, with a male predilection in either tumor. Localized pain was the most common presenting symptom. Neurological deficit at presentation was noted in 8/20 OBL patients, whereas all patients with OO were neurologically intact. Both the tumors predominantly involved posterior elements (27/31 patients) with no intradural involvement. Five patients (all with OO) underwent only decompression/curettage; 26/31 patients underwent decompression with instrumentation. 4 patients underwent Enneking inappropriate resection, with one patient having local tumor recurrence. Significant improvement in pre-existing neurological status and VAS scores was noted at final follow-up.

Surgical treatment of OBL and OO is associated with a favourable clinical, radiological and oncological outcome. While anatomical constraints don't allow wide excisions, combined Enneking and WBB staging facilitates surgical planning and helps in doing anatomically feasible resections with structural stability.