Resection of Spinal Osteoid Osteoma Assisted by 3D Planning. Case Report
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Published:
Jun 25, 2022
Keywords:
Osteoid osteoma, en bloc resection, 3D printing technology
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Abstract
The vertebral location of a lesion compatible with an osteoid osteoma often requires a marginal en bloc resection. Our objective is to present the use of 3D printing technology for the development of specific cutting guides that achieve a safe and complete resection of an L1 osteoid osteoma. We present the case of a 13-year-old male who underwent surgery for an L1 osteoid osteoma, detailing the preoperative planning assisted by 3D technology, the surgical technique using 3D printed cutting guides, a real model of the lumbar spine, and the postoperative control.
Conclusion: Before the surgical indication of a lesion compatible with an osteoid osteoma in the spine, we must decide between the possibility of an open intralesional resection or percutaneous and marginal en bloc resection. Different methods can be used for the intraoperative location of the lesion. In our department, we use 3D technology for preoperative planning of multiple acute and post-traumatic pathologies. This allows us to be precise and safe in the identification of intraoperative resection margins, minimizing the removal of healthy tissues and avoiding postoperative instability.
Conclusion: Before the surgical indication of a lesion compatible with an osteoid osteoma in the spine, we must decide between the possibility of an open intralesional resection or percutaneous and marginal en bloc resection. Different methods can be used for the intraoperative location of the lesion. In our department, we use 3D technology for preoperative planning of multiple acute and post-traumatic pathologies. This allows us to be precise and safe in the identification of intraoperative resection margins, minimizing the removal of healthy tissues and avoiding postoperative instability.
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How to Cite
Lombardo, E., Velez, M., & Verger, S. (2022). Resection of Spinal Osteoid Osteoma Assisted by 3D Planning. Case Report. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(3), 378-386. https://doi.org/10.15417/issn.1852-7434.2022.87.3.1206
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Case Presentations
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21. Van Royen BJ, Baayen JC, Pijpers R, Noske DP, Schakenraad D, Wuisman PI. Osteoid osteoma of the spine: a
novel technique using combined computer-assisted and gamma probe-guided high-speed intralesional drill excision. Spine (Phila Pa 1976) 2005;30(3):369-73. https://doi.org/10.1097/01.brs.0000152531.49095.34
22. Spetzger U, Frasca M, König SA. Surgical planning, manufacturing and implantation of an individualized cervical fusion titanium cage using patient-specific data. Eur Spine J 2016;25(7):2239-46. https://doi.org/10.1007/s00586-016-4473-9
23. Yang M, Li C, Li Y, Zhao Y, Wei X, Zhang G, et al. Application of 3D rapid prototyping technology in posterior
corrective surgery for Lenke 1 adolescent idiopathic scoliosis patients. Medicine (Baltimore) 2015;94(8):e582.
https://doi.org/10.1097/MD.0000000000000582
24. Sugawara T, Higashiyama N, Kaneyama S, Takabatake M, Watanabe N, Uchida F, et al. Multistep pedicle screw
insertion procedure with patient-specific lamina fit-and-lock templates for the thoracic spine: clinical article. J
Neurosurg Spine 2013;19(2):185-90. https://doi.org/10.3171/2013.4.SPINE121059
25. Hu Y, Yuan ZS, Spiker WR, Albert TJ, Dong WX, Xie H, et al. Deviation analysis of C2 translaminar screw placement assisted by a novel rapid prototyping drill template: a cadaveric study. Eur Spine J 2013;22(12):2770-6.
https://doi.org/10.1007/s00586-013-2993-0
1935;31(5):709-28. https://doi.org/10.1001/archsurg.1935.01180170034003
2. Cantwell CP, Obyrne J, Eustace S. Current trends in treatment of osteoid osteoma with an emphasis on
radiofrequency ablation. Eur Radiol 2004;14(4):607-17. https://doi.org/10.1007/s00330-003-2171-6
3. Gasbarrini A, Cappuccio M, Bandiera S, Amendola L, van Urk P, Boriani S. Osteoid osteoma of the mobile spine: surgical outcomes in 81 patients. Spine (Phila Pa 1976) 2011;36(24):2089-93. https://doi.org/10.1097/BRS.0b013e3181ffeb5e
4. Tello CA, Bersusky E, Francheri A, Noel M. Osteoma osteoide en la columna pediátrica. Rev Asoc Argent Ortop
Traumatol 1995;60(2):111-25. Disponible en: https://www.aaot.org.ar/revista/1993_2002/1995/1995_2/600201.pdf
5. Harish S, Saifuddin A. Imaging features of spinal osteoid osteoma with emphasis on MRI findings. Eur Radiol
2005;15(12):2396-403. https://doi.org/10.1007/s00330-005-2816-8
6. Lee EH, Shafi M, Hui JH. Osteoid osteoma: a current review. J Pediatr Orthop 2006;26(5):695-700. https://doi.org/10.1097/01.bpo.0000233807.80046.7c
7. Coulier B, Mailleux P, Munting E. Spontaneous remission of an osteoid osteoma of the axis. JBR-BTR 2005;88(1):43. PMID: 15792170
8. Segura FP, Segura FV. Tratamiento farmacológico del osteoma osteoide. A propósito de 4 casos. Rev Soc Ortop
Traumatol Córdoba 2006;6(1):21-4.
9. Slullitel H, Gruenberg M, Valacco M, Solá C, Ortolán E. Tratamiento quirúrgico del osteoma osteoide de la columna vertebral. Rev Asoc Argent Ortop Traumatol 2006;71(1):6-10. Disponible en: https://www.aaot.org.ar/revista/2006/n1_vol71/art1.pdf
10. Charosky S, Bernasconi JP, Coll P, Rudt T, Sierra P, Pedemonte M, et al. Osteoma osteoide de la columna vertebral. Comunicación de cuatro casos. Rev Asoc Argent Ortop Traumatol 2000;65(4):295-8. Disponible en:
https://www.aaot.org.ar/revista/1993_2002/2000/2000_4/650407.pdf
11. Kadhim M, Binitie O, O’Toole P, Grigoriou E, De Mattos CB, Dormans JP. Surgical resection of osteoid osteoma
and osteoblastoma of the spine. J Pediatr Orthop B 2017;26(4):362-9. https://doi.org/10.1097/BPB.0000000000000406
12. Nagashima H, Nishi T, Yamane K, Tanida A. Case report: osteoid osteoma of the C2 pedicle: surgical technique
using a navigation system. Clin Orthop Relat Res 2010;468(1):283-8. https://doi.org/10.1007/s11999-009-0958-8
13. Yoshioka K, Matsuda E, Murakami H, Tsuchiya H. Microendoscopic excision of osteoid osteoma in the pedicle of the third lumbar vertebra. Asian Spine J 2015;9(6):958-61. https://doi.org/10.4184/asj.2015.9.6.958
14. Esteban Cuesta H, Martel Villagran J, Bueno Horcajadas A, Kassarjian A, Rodriguez Caravaca G. Percutaneous
radiofrequency ablation in osteoid osteoma: Tips and tricks in special scenarios. Eur J Radiol 2018;102:169-75.
https://doi.org/10.1016/j.ejrad.2018.03.008
15. Xie T, Xiu P, Song Y, Zeng J, Huang S. Percutaneous endoscopic excision and ablation of osteoid osteoma of the lumbar spine and sacrum: A technical note and outcomes. World Neurosurg 2020;133:121-6. https://doi.org/10.1016/j.wneu.2019.09.039
16. Tsoumakidou G, Thénint MA, Garnon J, Buy X, Steib JP, Gangi A. Percutaneous image-guided laser
photocoagulation of spinal osteoid osteoma: A single-institution series. Radiology 2016;278(3):936-43. https://doi.org/10.1148/rdiol.2015150491
17. Albisinni U, Facchini G, Spinnato P, Gasbarrini A, Bazzocchi A. Spinal osteoid osteoma: efficacy and safety of
radiofrequency ablation. Skeletal Radiol 2017;46(8):1087-94. https://doi.org/10.1007/s00256-017-2662-1
18. Rehnitz C, Sprengel SD, Lehner B, Ludwig K, Omlor G, Merle C, et al. CT-guided radiofrequency ablation
of osteoid osteoma and osteoblastoma: clinical success and long-term follow up in 77 patients. Eur J Radiol 2012;81(11):3426-34. https://doi.org/10.1016/j.ejrad.2012.04.037
19. Ayala AG, Murray JA, Erling MA, Raymond AK. Osteoid-osteoma: intraoperative tetracycline-fluorescence
demonstration of the nidus. J Bone Joint Surg Am 1986;68(5):747-51. PMID: 3722233
20. Rajasekaran S, Kamath V, Shetty AP. Intraoperative Iso-C three-dimensional navigation in excision of spinal osteoid osteomas. Spine (Phila Pa 1976) 2008;33(1):E25-9. https://doi.org/10.1097/BRS.0b013e31815e6308
21. Van Royen BJ, Baayen JC, Pijpers R, Noske DP, Schakenraad D, Wuisman PI. Osteoid osteoma of the spine: a
novel technique using combined computer-assisted and gamma probe-guided high-speed intralesional drill excision. Spine (Phila Pa 1976) 2005;30(3):369-73. https://doi.org/10.1097/01.brs.0000152531.49095.34
22. Spetzger U, Frasca M, König SA. Surgical planning, manufacturing and implantation of an individualized cervical fusion titanium cage using patient-specific data. Eur Spine J 2016;25(7):2239-46. https://doi.org/10.1007/s00586-016-4473-9
23. Yang M, Li C, Li Y, Zhao Y, Wei X, Zhang G, et al. Application of 3D rapid prototyping technology in posterior
corrective surgery for Lenke 1 adolescent idiopathic scoliosis patients. Medicine (Baltimore) 2015;94(8):e582.
https://doi.org/10.1097/MD.0000000000000582
24. Sugawara T, Higashiyama N, Kaneyama S, Takabatake M, Watanabe N, Uchida F, et al. Multistep pedicle screw
insertion procedure with patient-specific lamina fit-and-lock templates for the thoracic spine: clinical article. J
Neurosurg Spine 2013;19(2):185-90. https://doi.org/10.3171/2013.4.SPINE121059
25. Hu Y, Yuan ZS, Spiker WR, Albert TJ, Dong WX, Xie H, et al. Deviation analysis of C2 translaminar screw placement assisted by a novel rapid prototyping drill template: a cadaveric study. Eur Spine J 2013;22(12):2770-6.
https://doi.org/10.1007/s00586-013-2993-0