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Navigated Pin-Point Approach to Osteoid Osteoma Adjacent to the Facet Joint of Spine.

Mori K, Neo M, Takemoto M, Nishizawa K, Imai S - Asian Spine J (2016)

Bottom Line: Accordingly, establishment of an ideal less invasive surgical strategy for spinal OO remains yet unsettled.We illustrate the efficacy of a computed tomography (CT)-based navigation system in excising OO located adjacent to the facet joint of spine.We advocate a less invasive approach to spinal OO, particularly in an environment with an available CT-based navigation system.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Sciencea, Otsu, Japan.

ABSTRACT
Osteoid osteoma (OO) is a benign osteoblastic tumor. Its curative treatment is complete removal of the nidus, where intraoperative localization of the nidus governs clinical results. However, treatment can be difficult since the lesion is often invisible over the bony surface. Accordingly, establishment of an ideal less invasive surgical strategy for spinal OO remains yet unsettled. We illustrate the efficacy of a computed tomography (CT)-based navigation system in excising OO located adjacent to the facet joint of spine. In our 2 cases, complete and pin-point removal of the nidus located close to the facet joint was successfully achieved, without excessive removal of the bone potentially leading to spinal instability and possible damage of nearby neurovascular structures. We advocate a less invasive approach to spinal OO, particularly in an environment with an available CT-based navigation system.

No MeSH data available.


Related in: MedlinePlus

Case 2. Postoperative plain X-ray of the cervical spine in flexion (A) and extension (B) positions at the latest follow-up, 3.5 years after surgery, showed no radiographic instability.
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Figure 7: Case 2. Postoperative plain X-ray of the cervical spine in flexion (A) and extension (B) positions at the latest follow-up, 3.5 years after surgery, showed no radiographic instability.

Mentions: Via navigation guidance, a trans-laminar tunnel reaching to the nidus was made using a high-speed drill. Then, complete removal of the nidus was achieved without sacrificing spinal stability (Fig. 5). The CT-based navigation system not only enabled pin-point removal of the nidus but also prevented possible damage of nearby critical structures (Fig. 5). Histopathological diagnosis of the resected lesion was that of OO (Fig. 6). Postoperative CT confirmed the complete removal of the nidus (Fig. 4C, D). At the time of the latest follow-up, 3.5 years after surgery, the patient was free of symptoms and there was no clinical or radiologic evidence for recurrence of the tumor (Fig. 7).


Navigated Pin-Point Approach to Osteoid Osteoma Adjacent to the Facet Joint of Spine.

Mori K, Neo M, Takemoto M, Nishizawa K, Imai S - Asian Spine J (2016)

Case 2. Postoperative plain X-ray of the cervical spine in flexion (A) and extension (B) positions at the latest follow-up, 3.5 years after surgery, showed no radiographic instability.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764529&req=5

Figure 7: Case 2. Postoperative plain X-ray of the cervical spine in flexion (A) and extension (B) positions at the latest follow-up, 3.5 years after surgery, showed no radiographic instability.
Mentions: Via navigation guidance, a trans-laminar tunnel reaching to the nidus was made using a high-speed drill. Then, complete removal of the nidus was achieved without sacrificing spinal stability (Fig. 5). The CT-based navigation system not only enabled pin-point removal of the nidus but also prevented possible damage of nearby critical structures (Fig. 5). Histopathological diagnosis of the resected lesion was that of OO (Fig. 6). Postoperative CT confirmed the complete removal of the nidus (Fig. 4C, D). At the time of the latest follow-up, 3.5 years after surgery, the patient was free of symptoms and there was no clinical or radiologic evidence for recurrence of the tumor (Fig. 7).

Bottom Line: Accordingly, establishment of an ideal less invasive surgical strategy for spinal OO remains yet unsettled.We illustrate the efficacy of a computed tomography (CT)-based navigation system in excising OO located adjacent to the facet joint of spine.We advocate a less invasive approach to spinal OO, particularly in an environment with an available CT-based navigation system.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Sciencea, Otsu, Japan.

ABSTRACT
Osteoid osteoma (OO) is a benign osteoblastic tumor. Its curative treatment is complete removal of the nidus, where intraoperative localization of the nidus governs clinical results. However, treatment can be difficult since the lesion is often invisible over the bony surface. Accordingly, establishment of an ideal less invasive surgical strategy for spinal OO remains yet unsettled. We illustrate the efficacy of a computed tomography (CT)-based navigation system in excising OO located adjacent to the facet joint of spine. In our 2 cases, complete and pin-point removal of the nidus located close to the facet joint was successfully achieved, without excessive removal of the bone potentially leading to spinal instability and possible damage of nearby neurovascular structures. We advocate a less invasive approach to spinal OO, particularly in an environment with an available CT-based navigation system.

No MeSH data available.


Related in: MedlinePlus