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Scoliosis secondary to lumbar osteoid osteoma

View Article: PubMed Central - PubMed

ABSTRACT

Rationale:: Lumbar osteoid osteoma has a low incidence, which could easily lead to scoliosis.

Patient concerns:: Scoliosis secondary to lumbar osteoid osteoma could be easily misdiagnosed when patients do not complain of obvious symptoms.

Diagnoses:: We reported a case of a 9-year-old boy with back deformity that was firstly diagnosed with scoliosis at the local hospital. After prescribed with orthosis, the patient experienced aggravating pain that could not be relieved with painkillers. After he admitted to our hospital for further medical advice, he was prescribed to complete radiological examinations. Considering his radiological examination results and his medical history, correct diagnosis of lumbar osteoid osteoma was made.

Interventions:: Surgical intervention of posterior lesion resection was conducted after diagnosis. Intra-operative frozen pathology indicated features of osteoid osteoma. As the lesion involved inferior articular process of L5, which could cause lumbar instability after lesion resection, internal fixation was conducted at L4-S1 segment, and posterolateral bone fusion was also conducted at L5-S1 segment.

Outcomes:: Three months after operation, the patient showed marked improvement of scoliosis deformity and great relief of lumbar pain.

Lessons subsections:: Although spine osteoid osteoma is clinically rare, it shall not be overlooked when young patients present with scoliosis first. Radiological results including computed tomography and magnetic resonance imaging shall be taken carefully as reference when making diagnosis. Surgical intervention of lesion resection could well improve scoliosis and relieve lumbar pain.

No MeSH data available.


A, Spine X-ray in 2014.11: T5-T12 Cobb: 36°, L1-L5: 20°. B, Spine X-ray in 2015.12: T5-T12 Cobb: 40°, L1-L5: 27°. C, Spine X-ray 1 week after surgery: T5-T12 Cobb: 15°, L1-L5: 20°. D, Spine X-ray 3 months after surgery: T5-T12 Cobb: 10°, L1-L5: 12°.
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Figure 1: A, Spine X-ray in 2014.11: T5-T12 Cobb: 36°, L1-L5: 20°. B, Spine X-ray in 2015.12: T5-T12 Cobb: 40°, L1-L5: 27°. C, Spine X-ray 1 week after surgery: T5-T12 Cobb: 15°, L1-L5: 20°. D, Spine X-ray 3 months after surgery: T5-T12 Cobb: 10°, L1-L5: 12°.

Mentions: A 9-year-old boy admitted to our hospital on December 11, 2015 complaining of scoliosis for 1 year and lumbar pain for half a year. The patient presented back deformity with asymmetrical shoulder height 1 year ago, and he admitted to the local hospital. X-ray examination was prescribed, revealing scoliosis with thoracic Cobb angle from T5 to T12 to be 36° and lumbar Cobb angle from L1 to L5 to be 20° (Fig. 1A). The patient was prescribed with orthosis, and he suffered from aggravating lumbar sacral discomfort considered to be due to scoliosis. Painkillers were later prescribed at the local hospital, which could not relieve the symptoms. As the patient experienced repeated lumbar sacral discomfort and aggravating pain, he came to our institution for further medical advice.


Scoliosis secondary to lumbar osteoid osteoma
A, Spine X-ray in 2014.11: T5-T12 Cobb: 36°, L1-L5: 20°. B, Spine X-ray in 2015.12: T5-T12 Cobb: 40°, L1-L5: 27°. C, Spine X-ray 1 week after surgery: T5-T12 Cobb: 15°, L1-L5: 20°. D, Spine X-ray 3 months after surgery: T5-T12 Cobb: 10°, L1-L5: 12°.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134864&req=5

Figure 1: A, Spine X-ray in 2014.11: T5-T12 Cobb: 36°, L1-L5: 20°. B, Spine X-ray in 2015.12: T5-T12 Cobb: 40°, L1-L5: 27°. C, Spine X-ray 1 week after surgery: T5-T12 Cobb: 15°, L1-L5: 20°. D, Spine X-ray 3 months after surgery: T5-T12 Cobb: 10°, L1-L5: 12°.
Mentions: A 9-year-old boy admitted to our hospital on December 11, 2015 complaining of scoliosis for 1 year and lumbar pain for half a year. The patient presented back deformity with asymmetrical shoulder height 1 year ago, and he admitted to the local hospital. X-ray examination was prescribed, revealing scoliosis with thoracic Cobb angle from T5 to T12 to be 36° and lumbar Cobb angle from L1 to L5 to be 20° (Fig. 1A). The patient was prescribed with orthosis, and he suffered from aggravating lumbar sacral discomfort considered to be due to scoliosis. Painkillers were later prescribed at the local hospital, which could not relieve the symptoms. As the patient experienced repeated lumbar sacral discomfort and aggravating pain, he came to our institution for further medical advice.

View Article: PubMed Central - PubMed

ABSTRACT

Rationale:: Lumbar osteoid osteoma has a low incidence, which could easily lead to scoliosis.

Patient concerns:: Scoliosis secondary to lumbar osteoid osteoma could be easily misdiagnosed when patients do not complain of obvious symptoms.

Diagnoses:: We reported a case of a 9-year-old boy with back deformity that was firstly diagnosed with scoliosis at the local hospital. After prescribed with orthosis, the patient experienced aggravating pain that could not be relieved with painkillers. After he admitted to our hospital for further medical advice, he was prescribed to complete radiological examinations. Considering his radiological examination results and his medical history, correct diagnosis of lumbar osteoid osteoma was made.

Interventions:: Surgical intervention of posterior lesion resection was conducted after diagnosis. Intra-operative frozen pathology indicated features of osteoid osteoma. As the lesion involved inferior articular process of L5, which could cause lumbar instability after lesion resection, internal fixation was conducted at L4-S1 segment, and posterolateral bone fusion was also conducted at L5-S1 segment.

Outcomes:: Three months after operation, the patient showed marked improvement of scoliosis deformity and great relief of lumbar pain.

Lessons subsections:: Although spine osteoid osteoma is clinically rare, it shall not be overlooked when young patients present with scoliosis first. Radiological results including computed tomography and magnetic resonance imaging shall be taken carefully as reference when making diagnosis. Surgical intervention of lesion resection could well improve scoliosis and relieve lumbar pain.

No MeSH data available.