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Case Report: Osteoid Osteoma of the C2 Pedicle: Surgical Technique Using a Navigation System

  • Hideki NagashimaEmail author
  • Takako Nishi
  • Koji Yamane
  • Atsushi Tanida
Case Report

Abstract

An osteoid osteoma of the cervical spinal pedicle is rare and carries a high surgical risk because of the close anatomic relationship to the spinal cord, nerve root, and vertebral artery. We report the case of a 12-year-old girl with an osteoid osteoma of the C2 pedicle. Computed tomograms showed an oval nidus and marked sclerosis around this lesion at the right C2 pedicle. There also was expansion of the medial and inferior cortical bone of the C2 pedicle. After failure of nonoperative treatment, we planned surgery. Owing to concerns regarding thermal damage to the spinal cord, nerve root, and/or vertebral artery using computed tomography (CT)-guided radiofrequency ablation, we curetted the nidus using a navigation system. Twenty-eight months after surgery, her pain was relieved with no limitation of cervical movement and there has been no evidence of recurrence. Navigation allowed safe curettage of the nidus through a small hole while maintaining spinal stability.

Keywords

Celecoxib Nerve Root Navigation System Vertebral Artery Neck Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank Drs. Koji Endo, Hideki Yamashita, Mari Osaki, and Yuki Hamamoto, Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, for help with histologic interpretation and photography.

References

  1. 1.
    Barei DP, Moreau G, Scarborough MT, Neel MD. Percutaneous radiofrequency ablation of osteoid osteoma. Clin Orthop Relat Res. 2000;373:115–124.CrossRefPubMedGoogle Scholar
  2. 2.
    Biswas D, Mal RK. Dysphagia secondary to osteoid osteoma of the transverse process of the second cervical vertebra. Dysphagia. 2007;22:73–75.CrossRefPubMedGoogle Scholar
  3. 3.
    Boriani S, Capanna R, Donati D, Levine A, Picci P, Savini R. Osteoblastoma of the spine. Clin Orthop Relat Res. 1992;278:37–45.PubMedGoogle Scholar
  4. 4.
    Bruneau M, Cornelius JF, George B. Osteoid osteomas and osteoblastomas of the occipitocervical junction. Spine. 2005;30:E567–E571.CrossRefPubMedGoogle Scholar
  5. 5.
    Coulier B, Mailleux P, Munting E. Spontaneous remission of an osteoid osteoma of the axis. JBR-BTR. 2005;88:43.PubMedGoogle Scholar
  6. 6.
    Crouzet G, Mnif J, Vasdev A, Pascal-Ortiz D, Chirossel JP, Pasquier B. Osteoid osteoma of the spine: radiological aspects and value of arteriography. Four cases. J Neuroradiol. 1989;16:145–159.PubMedGoogle Scholar
  7. 7.
    Faraj A, Byrne P, Mehdian H. Osteoid osteoma of the lateral mass of C5: should excision be combined with fusion? Eur Spine J. 1998;7:242–245.CrossRefPubMedGoogle Scholar
  8. 8.
    Fountain EM, Burge CH. Osteoid osteoma of the cervical spine: a review and case report. J Neurosurg. 1961;18:380–383.CrossRefPubMedGoogle Scholar
  9. 9.
    Geerling J, Gösling T, Gösling A, Ortega G, Kendoff D, Citak M, Krettek C, Hüfner T. Navigated pedicle screw placement: experimental comparison between CT- and 3D fluoroscopy-based techniques. Comput Aided Surg. 2008;13:157–166.CrossRefPubMedGoogle Scholar
  10. 10.
    Gitelis S, McDonald DJ. Common benign bone tumors and usual treatment. In: Simon MA, Springfield D, eds. Surgery for Bone and Soft-Tissue Tumors. Philadelphia, PA: Lippincott-Raven; 1998:181–205.Google Scholar
  11. 11.
    Hadjipavlou AG, Lander PH, Marchesi D, Katonis PG, Gaitanis IN. Minimally invasive surgery for ablation of osteoid osteoma of the spine. Spine. 2003;28:E472–E477.CrossRefPubMedGoogle Scholar
  12. 12.
    Holly LT, Foley KT. Intraoperative spinal navigation. Spine. 2003;28(15 suppl):S54–S61.CrossRefPubMedGoogle Scholar
  13. 13.
    Ito Y, Sugimoto Y, Tomioka M, Hasegawa Y, Nakago K, Yagata Y. Clinical accuracy of 3D fluoroscopy-assisted cervical pedicle screw insertion. J Neurosurg Spine. 2008;9:450–453.CrossRefPubMedGoogle Scholar
  14. 14.
    Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid-osteoma. J Bone Joint Surg Am. 1992;74:179–185.PubMedGoogle Scholar
  15. 15.
    Laus M, Albisinni U, Alfonso C, Zappoli FA. Osteoid osteoma of the cervical spine: surgical treatment or percutaneous radiofrequency coagulation? Eur Spine J. 2007;16:2078–2082.CrossRefPubMedGoogle Scholar
  16. 16.
    Marcove RC, Heelan RT, Huvos AG, Healey J, Lindeque BG. Osteoid osteoma: diagnosis, localization, and treatment. Clin Orthop Relat Res. 1991;267:197–201.PubMedGoogle Scholar
  17. 17.
    Martel J, Bueno Á, Nieto-Morales ML, Ortiz EJ. Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation. Eur J Radiol. 2008 May 31. [Epub ahead of print]Google Scholar
  18. 18.
    Matsuura M, Nakamura H, Inoue Y, Yamano Y. Osteoid osteoma of the cervical spine depicted as dumbbell tumor by MRI. Eur Spine J. 2000;9:426–429.CrossRefPubMedGoogle Scholar
  19. 19.
    McLeod RA, Dahlin DC, Beabout JW. The spectrum of osteoblastoma. Am J Roentgenol. 1976;126:321–325.Google Scholar
  20. 20.
    Molloy S, Saifuddin A, Allibone J, Taylor BA. Excision of an osteoid osteoma from the body of the axis through an anterior approach. Eur Spine J. 2002;11:599–601.CrossRefPubMedGoogle Scholar
  21. 21.
    Muthukumar N. Osteoid osteoma: a rare cause of brachial neuralgia. Childs Nerv Syst. 2002;18:161–163.CrossRefPubMedGoogle Scholar
  22. 22.
    Neumann D, Dorn U. Osteoid osteoma of the dens axis. Eur Spine J. 2007;16(suppl 3):271–274.CrossRefPubMedGoogle Scholar
  23. 23.
    Osti OL, Sebben R. High-frequency radio-wave ablation of osteoid osteoma in the lumbar spine. Eur Spine J. 1998;7:422–425.CrossRefPubMedGoogle Scholar
  24. 24.
    Ozaki T, Liljenqvist U, Hillmann A, Halm H, Lindner N, Gosheger G, Winkelmann W. Osteoid osteoma and osteoblastoma of the spine: experiences with 22 patients. Clin Orthop Relat Res. 2002;397:394–402.CrossRefPubMedGoogle Scholar
  25. 25.
    Rajasekaran S, Kamath V, Shetty AP. Intraoperative Iso-C three-dimensional navigation in excision of spinal osteoid osteomas. Spine. 2008;33:E25–E29.CrossRefPubMedGoogle Scholar
  26. 26.
    Raskas DS, Graziano GP, Herzenberg JE, Heidelberger KP, Hensinger RN. Osteoid osteoma and osteoblastoma of the spine. J Spinal Disord. 1992;5:204–211.CrossRefPubMedGoogle Scholar
  27. 27.
    Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ. Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology. 2003;229:171–175.CrossRefPubMedGoogle Scholar
  28. 28.
    Suttner NJ, Chandy KJ, Kellerman AJ. Osteoid osteomas of the body of the cervical spine: case report and review of the literature. Br J Neurosurg. 2002;16:69–71.CrossRefPubMedGoogle Scholar
  29. 29.
    Zambelli PY, Lechevallier J, Bracq H, Carlioz H. Osteoid osteoma or osteoblastoma of the cervical spine in relation to the vertebral artery. J Pediatr Orthop. 1994;14:788–792.PubMedGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  • Hideki Nagashima
    • 1
    Email author
  • Takako Nishi
    • 2
  • Koji Yamane
    • 3
  • Atsushi Tanida
    • 1
  1. 1.Department of Orthopedic Surgery, Faculty of MedicineTottori UniversityYonago, TottoriJapan
  2. 2.Department of Orthopaedic SurgeryYoshida Orthopaedic HospitalToyotaJapan
  3. 3.Department of Orthopedic SurgeryTottori Red Cross HospitalTottoriJapan

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