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Osteoid osteoma near the intervertebral foramen may induce radiculopathy through tumorous inflammation.

Zenmyo M, Yamamoto T, Ishidou Y, Komiya S, Ijiri K - Diagn Pathol (2011)

Bottom Line: Although radicular pain occasionally occurs in spinal osteoid osteoma, spinal cord and nerve root compression is absent in most cases.Although radicular pain appears to be associated with tumorous inflammation, there have been no presentations of histological findings of inflammation around the nerve root.We present here two rare cases of spinal osteoid osteoma causing radiculopathy and the first histological evidence of tumorous inflammation as a cause of radiculopathy in osteoid osteoma near the intervertebral foramen.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

ABSTRACT
Osteoid osteoma of the spine is a relatively rare bone-forming tumor. Pain that is worse at night and relieved by aspirin and muscle contracture are the most characteristic symptoms of spinal osteoid osteoma. Although radicular pain occasionally occurs in spinal osteoid osteoma, spinal cord and nerve root compression is absent in most cases. Although radicular pain appears to be associated with tumorous inflammation, there have been no presentations of histological findings of inflammation around the nerve root. We present here two rare cases of spinal osteoid osteoma causing radiculopathy and the first histological evidence of tumorous inflammation as a cause of radiculopathy in osteoid osteoma near the intervertebral foramen.

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Conventional roentgenogram, CT and Gd-enhanced MR images. A; Anteroposterior radiograph of the thoracic spine revealed no abnormalities. B: CT revealed marked perilesional sclerosis of bone in the right facet. C, D, and E: Gd-enhanced area extended over the intervertebral foramen and the nerve root.
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Figure 3: Conventional roentgenogram, CT and Gd-enhanced MR images. A; Anteroposterior radiograph of the thoracic spine revealed no abnormalities. B: CT revealed marked perilesional sclerosis of bone in the right facet. C, D, and E: Gd-enhanced area extended over the intervertebral foramen and the nerve root.

Mentions: Anteroposterior radiographs of the thoracic spine revealed few distinct abnormalities in the thoracic spine (Figure 3A). Radionuclide bone scan revealed increased uptake of isotope in T11 on the right side. Although MRI demonstrated signal alteration in the facet of T10/11, no nidus was visualized. A high-intensity area on T2-weighted images that was enhanced by Gd-DTPA was present over the T10 nerve root (Figure 3C-E). These MRI findings indicated inflammation and consequent edema. In contrast to MRI, CT revealed intense reactive sclerosis surrounding the nidus in the tip of the superior articular process of T11 (Figure 3B), with no compression of the nerve root on axial view. Selective T10 nerve root block was performed as a diagnostic-therapeutic test, with improvement of the radiating pain.


Osteoid osteoma near the intervertebral foramen may induce radiculopathy through tumorous inflammation.

Zenmyo M, Yamamoto T, Ishidou Y, Komiya S, Ijiri K - Diagn Pathol (2011)

Conventional roentgenogram, CT and Gd-enhanced MR images. A; Anteroposterior radiograph of the thoracic spine revealed no abnormalities. B: CT revealed marked perilesional sclerosis of bone in the right facet. C, D, and E: Gd-enhanced area extended over the intervertebral foramen and the nerve root.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3038875&req=5

Figure 3: Conventional roentgenogram, CT and Gd-enhanced MR images. A; Anteroposterior radiograph of the thoracic spine revealed no abnormalities. B: CT revealed marked perilesional sclerosis of bone in the right facet. C, D, and E: Gd-enhanced area extended over the intervertebral foramen and the nerve root.
Mentions: Anteroposterior radiographs of the thoracic spine revealed few distinct abnormalities in the thoracic spine (Figure 3A). Radionuclide bone scan revealed increased uptake of isotope in T11 on the right side. Although MRI demonstrated signal alteration in the facet of T10/11, no nidus was visualized. A high-intensity area on T2-weighted images that was enhanced by Gd-DTPA was present over the T10 nerve root (Figure 3C-E). These MRI findings indicated inflammation and consequent edema. In contrast to MRI, CT revealed intense reactive sclerosis surrounding the nidus in the tip of the superior articular process of T11 (Figure 3B), with no compression of the nerve root on axial view. Selective T10 nerve root block was performed as a diagnostic-therapeutic test, with improvement of the radiating pain.

Bottom Line: Although radicular pain occasionally occurs in spinal osteoid osteoma, spinal cord and nerve root compression is absent in most cases.Although radicular pain appears to be associated with tumorous inflammation, there have been no presentations of histological findings of inflammation around the nerve root.We present here two rare cases of spinal osteoid osteoma causing radiculopathy and the first histological evidence of tumorous inflammation as a cause of radiculopathy in osteoid osteoma near the intervertebral foramen.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

ABSTRACT
Osteoid osteoma of the spine is a relatively rare bone-forming tumor. Pain that is worse at night and relieved by aspirin and muscle contracture are the most characteristic symptoms of spinal osteoid osteoma. Although radicular pain occasionally occurs in spinal osteoid osteoma, spinal cord and nerve root compression is absent in most cases. Although radicular pain appears to be associated with tumorous inflammation, there have been no presentations of histological findings of inflammation around the nerve root. We present here two rare cases of spinal osteoid osteoma causing radiculopathy and the first histological evidence of tumorous inflammation as a cause of radiculopathy in osteoid osteoma near the intervertebral foramen.

Show MeSH
Related in: MedlinePlus