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Recurrent burner syndrome due to presumed cervical spine osteoblastoma in a collision sport athlete - a case report.

Elias I, Pahl MA, Zoga AC, Goins ML, Vaccaro AR - J Brachial Plex Peripher Nerve Inj (2007)

Bottom Line: Radiographically, the lesion had features typical for a large osteoid osteoma or osteoblastoma, including osseous expansion, peripheral sclerosis and bony hypertrophy, internal lucency, and even suggestion of a central nidus.The surgery revealed very good clinical results.In this report, we will discuss in detail, the presentation, treatment, and return to play recommendations involving this patient.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA. ilan.elias@rothmaninstitute.com

ABSTRACT
We present a case of a 35-year-old active rugby player presenting with a history of recurrent burner syndrome thought secondary to an osteoblastoma involving the posterior arch of the atlas. Radiographically, the lesion had features typical for a large osteoid osteoma or osteoblastoma, including osseous expansion, peripheral sclerosis and bony hypertrophy, internal lucency, and even suggestion of a central nidus. The patient subsequently underwent an en bloc resection of the posterior atlas via a standard posterior approach. The surgery revealed very good clinical results. In this report, we will discuss in detail, the presentation, treatment, and return to play recommendations involving this patient.

No MeSH data available.


Related in: MedlinePlus

Histologically, the bony trabeculae are thickened and woven bone formation is identified at the cortical surface of the lesion. Lamellar bone formation is centrally identified. There is no evidence of nidus formation. The medullary component shows trilineage hematopoiesis and there is no definitive evidence of a neoplasm. The lesions are interpreted as reactive bone formation.
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Figure 4: Histologically, the bony trabeculae are thickened and woven bone formation is identified at the cortical surface of the lesion. Lamellar bone formation is centrally identified. There is no evidence of nidus formation. The medullary component shows trilineage hematopoiesis and there is no definitive evidence of a neoplasm. The lesions are interpreted as reactive bone formation.

Mentions: The patient subsequently underwent an en bloc resection of the posterior atlas via a posterior approach. The lamina was resected out to the margins of the C1 isthmus and vertebral arteries bilaterally. Intraoperative neuromonitoring did not reveal any abnormality prior to or following tumor resection. Due to the presence of myelomalacia and the potential for excessive neural shear stress from cervical flexion or rotation, a fusion procedure was considered, but the lack of anticipated spinal instability after surgical removal of the C1 lamina lead the patient to elect against the fusion. The surgical specimen was sent to pathology where it was noted to be consistent with simple benign osseous hypertrophy; neither consistent with an osteoid osteoma or osteoblastoma on histological analysis (Figure 4).


Recurrent burner syndrome due to presumed cervical spine osteoblastoma in a collision sport athlete - a case report.

Elias I, Pahl MA, Zoga AC, Goins ML, Vaccaro AR - J Brachial Plex Peripher Nerve Inj (2007)

Histologically, the bony trabeculae are thickened and woven bone formation is identified at the cortical surface of the lesion. Lamellar bone formation is centrally identified. There is no evidence of nidus formation. The medullary component shows trilineage hematopoiesis and there is no definitive evidence of a neoplasm. The lesions are interpreted as reactive bone formation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1904218&req=5

Figure 4: Histologically, the bony trabeculae are thickened and woven bone formation is identified at the cortical surface of the lesion. Lamellar bone formation is centrally identified. There is no evidence of nidus formation. The medullary component shows trilineage hematopoiesis and there is no definitive evidence of a neoplasm. The lesions are interpreted as reactive bone formation.
Mentions: The patient subsequently underwent an en bloc resection of the posterior atlas via a posterior approach. The lamina was resected out to the margins of the C1 isthmus and vertebral arteries bilaterally. Intraoperative neuromonitoring did not reveal any abnormality prior to or following tumor resection. Due to the presence of myelomalacia and the potential for excessive neural shear stress from cervical flexion or rotation, a fusion procedure was considered, but the lack of anticipated spinal instability after surgical removal of the C1 lamina lead the patient to elect against the fusion. The surgical specimen was sent to pathology where it was noted to be consistent with simple benign osseous hypertrophy; neither consistent with an osteoid osteoma or osteoblastoma on histological analysis (Figure 4).

Bottom Line: Radiographically, the lesion had features typical for a large osteoid osteoma or osteoblastoma, including osseous expansion, peripheral sclerosis and bony hypertrophy, internal lucency, and even suggestion of a central nidus.The surgery revealed very good clinical results.In this report, we will discuss in detail, the presentation, treatment, and return to play recommendations involving this patient.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA. ilan.elias@rothmaninstitute.com

ABSTRACT
We present a case of a 35-year-old active rugby player presenting with a history of recurrent burner syndrome thought secondary to an osteoblastoma involving the posterior arch of the atlas. Radiographically, the lesion had features typical for a large osteoid osteoma or osteoblastoma, including osseous expansion, peripheral sclerosis and bony hypertrophy, internal lucency, and even suggestion of a central nidus. The patient subsequently underwent an en bloc resection of the posterior atlas via a standard posterior approach. The surgery revealed very good clinical results. In this report, we will discuss in detail, the presentation, treatment, and return to play recommendations involving this patient.

No MeSH data available.


Related in: MedlinePlus