OO is a benign bone lesion with high incidence at the age between 10 and 20 . It occurs more in extremities than in spine [2, 3]. The lumbar spine is the most commonly affected area, followed by the cervical, thoracic, and sacral regions . The diagnosis of OO is primarily clinical. In typical cases, it is characterized by inflammatory pain at night [2, 5,6,7]. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain . This is a diagnostic test. The pain is due to irritation of the nerve fibers in contact with the nidus  and the peritumoral inflammatory reaction due to prostaglandins (cyclooxygenase-2) . Scoliosis is mainly due to muscle spasms and chronic inflammatory reactions surrounding the tumor. [4, 5]. If the diagnosis is late, a structured scoliosis forms with spinal rotation . It has been demonstrated that for the spinal location of OO, the diagnostic delay can reach 54% in some series . The X-ray of the entire spine makes it possible to study the frontal and sagittal balance of the spine, in particular to classify scoliosis and to objectify spinal rotation (structured scoliosis). CT allows a good study of OO by objectifying the nidus centered by calcifications and peripheral bone condensation . Bone scintigraphy allows precise localization of the lesion . MRI is an essential adjunct. It makes it possible to eliminate a malignant tissue process, to check that there is no spinal or root compression and to objectify the peri-lesional edema. Surgical treatment consists of resection of the entire tumor, preferably in one piece , to ensure healing without risk of recurrence. Treatment of spinal OO can also be done by radiofrequency [11, 12], but the risk of neurological damage is high, particularly for locations in the posterior column. This should remain a contraindication until further notice . For the management of scoliosis, when it is non-structural, the deformity spontaneously reduces after resection of the OO and the disappearance of local inflammatory signs. The problem arises with structured scoliosis. In this case, we recommend a non-operative treatment to preserve spinal mobility. But in case, resection of the articular process causes spinal instability, treatment with posterior instrumentation and fusion becomes a potential treatment option .