Skip to main content
SpringerLink
Log in

Wide surgical excision for osteoid osteoma. Should it be the first-choice treatment?

Excision large pour les ostéomes ostéoïdes?

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Osteoid osteomas (OO) are benign skeletal tumors with a predilection for the long bones of young patients. Many different methods are used for their treatment, conservative or operative, less or more radical, with variable technology applications to destroy the “nidus.” We present 38 patients with OO who were treated in our hospital between 1995–2001. Their medical records and radiographs were retrospectively reviewed, and the patients were contacted and interviewed by telephone. In 32 patients, OO were located in the lower limb, in two the upper limb, and in four the spine. Thirty-seven patients were treated operatively using open wide excision of the nidus. In 22 of those patients, additional bone grafting was used. In three patients, prophylactic internal fixation was applied to the bone. Two patients developed deep-vein thrombosis; another two had increased pain in the anterior superior iliac spine from the bone graft harvesting area. We had one recurrence, which was treated with a second operation. We conclude that although the traditional method of treatment is wide surgical excision, this technique has increased morbidity and higher risk for complications compared to more minimally invasive procedures. We suggest that it should be the first choice of treatment for either spinal or recurrent OO.

Résumé

Les auteurs rapportent une série de 38 ostéomes ostéoides traités entre 1995 et 2001. La localisation était au membre inférieur dans 32 cas, au membre supérieur dans 2 et au rachis dans 4. Le traitement a été une résection large avec excision du nidus dans 37 cas; 22 fois une greffe a été réalisée et 3 fois une ostéosynthèse de précaution. Dans le suites 2 patients ont développé une thrombose veineuse profonde, 2 autres des douleurs au niveau du site de prélèvement de la greffe. Une récidive a nécessité une réintervention. Le traitement chirurgical par résection large comporte une morbidité supérieure à celle de techniques moins invasives qui devraient être maintenant considérées comme les méthodes de choix de première intention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4a, b

Similar content being viewed by others

References

  1. Assoun J, Richardi G, Railhac JJ et al (1994) Osteoid osteoma: MR imaging versus CT. Radiology 191:217–223

    CAS  PubMed  Google Scholar 

  2. Assoun J, Jourlaud T, Chiavassu H, Bonnevialle P, Railhuc N, Giron J, Morera-Maupome H, Railhuc JJ (1999) Osteoid osteoma: CT-guided percutaneous resection and follow-up in 38 patients. Radiology 212:687–692

    CAS  PubMed  Google Scholar 

  3. Barei DP, Moreau G, Scarborough MT, Noel MD (2000) Percutaneous radiofrequency ablation of osteoid osteoma. Clin Orthop 373:115–124

    PubMed  Google Scholar 

  4. Buhler M, Binkert C, Exner G (2001) Osteoid osteoma: technique of computed tomography-controlled percutaneous resection using standard equipment available in most orthopaedic operation rooms. Arch.Orthop.Trauma Surg 121:458–461

    CAS  Google Scholar 

  5. Campanacci M (1990) Bone and soft tissue tumors. Springer, Berlin, Heidelberg, New York, p 355

  6. Campanacci M, Ruggieri P, Gasparini A, Ferrano A, Campanacci L(1999) Osteoid osteoma. Direct visual identification and intralesional excision of the nidus with minimal removal of bone. J Bone Joint Surg Br 81:814–820

    CAS  PubMed  Google Scholar 

  7. Dahlin DC, Unni KK (1987) Bone tumours: general aspects and data on 8542 cases, 4th edn. Thomas, Springfield, pp 88–101

    Google Scholar 

  8. de Berg JC, Pattynama PM, Oberman WR, et al (1995) Percutaneous computed-tomography guided thermocoagulation for osteoid osteomas. Lancet 346:350–351

    PubMed  Google Scholar 

  9. Doyle T, King K (1989) Percutaneous removal of osteoid osteoma using CT control. Clin Radiol 40(5):514–517

    CAS  PubMed  Google Scholar 

  10. Duda SH, Schnaatterbeck P, Harer T, et al (1997) Treatment of osteoid osteoma with CT-guided drilling and ethanol instillation. Dtsch Med Wochenschr 122:507–510

    CAS  PubMed  Google Scholar 

  11. Ennecking WF (1993) Osteoma. Musculoskeletal Tumor Surgery Vol 2, New York, Churchill Livingstone pp.1023–1031

  12. Frassica FJ, Waltrip RL, Sponseller DD, Ma L, McCarthy EF (1996) Clinicopathologic features and treatment of osteoid osteomas and osteoblastoma in children and adolescents. Orthop Clin North Am 27:559–574

    CAS  PubMed  Google Scholar 

  13. Freiberger RH, Loitman BS, Helpern M, Thompson TC (1959) Osteoid osteoma: a report of 80 cases. AJR 82:194–205

    CAS  Google Scholar 

  14. Gangi A, Dietemann JL, Gasser B, et al (1997) Interstitial laser photocoagulation of osteoid osteomas with use of CT-guidance. Radiology 203:843–848

    CAS  PubMed  Google Scholar 

  15. Gangi A, Dietemann JL, Gasser B, et al (1997) Percutaneous Laser Photocoagulation of osteoid osteomas. Semin Musculoskelet Radiol 1(2):273–280

    PubMed  Google Scholar 

  16. Georgulis AD, Soucacos PN, Beris AE, Xenakis TA (1995) Osteoid osteoma in the differential diagnosis of persistent joint pain. Knee Surgery, Sports Traumatology, Arthroscopy 3:125–128

  17. Gitelis S, Schajowicz F (1989) Osteoid osteoma and osteoblastoma. Orthop Clin North Am 20:313–325

    CAS  PubMed  Google Scholar 

  18. Golding JSR (1954) The natural history of osteoid osteoma with report of 20 cases. J Bone Joint Surg Br 36:218–229

    Google Scholar 

  19. Jackson RP, Reckling FW, Mantz FA (1997) Osteoid osteoma and osteoblastoma: Similar histologic lesions with different natural histories. Clin Orthop 128:303

    Google Scholar 

  20. Jaffe H (1935) Osteoid osteoma, a benign osteoblastic tumor composed of osteoid and atypical bone. Arch Surg.31;709

  21. Kattapuram SV, Kushner DC, Phillips WC, Rosenthal DI (1983) Osteoid osteoma: an unusual cause of articular pain. Radiology 147:383–384

    CAS  PubMed  Google Scholar 

  22. Kendrick JI, Evans CM (1967) Osteoid osteoma: a critical analysis of 40 tumours. Clin Orthop. 54:51–59

    Google Scholar 

  23. Kransdorf MJ, Gilkey FW, Stull MA, Moser RP (1991) Osteoid osteoma. Radiographics 11:671–697

    CAS  PubMed  Google Scholar 

  24. Lee DH, Malawer MM (1992) Staging and treatment of primary and persistent (recurrent) osteoid osteoma: evaluation of intraoperative nuclear scanning, tetracycline fluorescence and tomography. Clin Orthop 281:229–238

    PubMed  Google Scholar 

  25. Lindner NJ, Ozaki T, Roed R, Gosheger G, Winkelmann W, Wortler K (2001) Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg Br 83:391–396

    CAS  PubMed  Google Scholar 

  26. Marcove RC, Heelan RT, Hubox AG, Healey J, Lindeque BG (1991) Osteoid osteoma, diagnosis, localization and treatment. Clin Orthop. 267:197–201

    Google Scholar 

  27. Mirra J (1980) Bone tumors: Diagnosis and treatment, 1st edn, Lippincott, Philadelphia p 97–107

    Google Scholar 

  28. Moberg E (1951) Natural course of osteoid osteoma. J Bone Joint Surg Am 33:166–170

    CAS  PubMed  Google Scholar 

  29. Norman A (1978) Persistence of recurrence of pain: a sign of surgical failure in osteoid osteoma. Clin Orthop 130:263–266

    PubMed  Google Scholar 

  30. Radcliffe SN, Walsh HJ, Carty H (1998) Osteoid osteoma : the difficult diagnosis. European Journal Radiology 28:67–79

    Article  CAS  Google Scholar 

  31. Smith FW, Gilday DL(1980) Scintigraphic appearances of osteoid osteoma. Radiology 137:191–195

    CAS  PubMed  Google Scholar 

  32. Spence AJ, Lloyd-Roberts GC (1961) Regional osteoporosis in osteoid osteoma. J Bone Joint Surg Br 43:501–507

    Google Scholar 

  33. Swee RG, McLeod RA, Beabout JW (1979) Osteoid osteoma: defection, diagnosis and localization. Radiology 130:117–123

    CAS  PubMed  Google Scholar 

  34. Tauber C, Copeliovitch L, Halperin N and Mulkin C (1987) Computerized tomography in the diagnosis and treatment of osteoid osteoma. Arch Orthop Trauma Surg 106:364

    CAS  PubMed  Google Scholar 

  35. Ward WG, Eckardt JJ, Shoyestehfar S, Mira J, Grogan T, Oppenheim W (1993) Osteoid osteoma diagnosis and managment with low morbidity. Clin Orthop 291:229–235

    PubMed  Google Scholar 

  36. Witt JD, Hall-Cruggs MA, Ripley P, Cobb P, Bown SG (2000) Interstitial laser photocoagulation for the treatment of osteoid osteoma. J Bone Joint Surg Br 82:1125–1128

    Article  CAS  PubMed  Google Scholar 

  37. Woertler K, Vestring T, Boettner F, Winkelman W, Heindel W, Lindner N (2001) Osteoid osteoma: CT-guided Percutaneous Radiofrequency Ablation and follow up in 47 patients. J Vasc Interv Radiol 12:717–722

    CAS  PubMed  Google Scholar 

  38. Yamamura S, K.Sato, H.Sugiura, M.Asano, M.Takahashi, H.Iwata (1994) Magnetic resonance imaging of inflammatory reaction in osteoid osteoma. Arch Orthop Trauma Surg 114:8–13

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Trauma and Orthopaedic Surgery, 424 General Military Hospital, 158 Egnatia Str, 54621, Thessaloniki, Greece

    I. Bisbinas & T. Karanasos

  2. Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX, UK

    D Georgiannos

Authors
  1. I. Bisbinas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D Georgiannos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Karanasos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Georgiannos.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bisbinas, I., Georgiannos, D. & Karanasos, T. Wide surgical excision for osteoid osteoma. Should it be the first-choice treatment?. Eur J Orthop Surg Traumatol 14, 151–154 (2004). https://doi.org/10.1007/s00590-004-0150-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-004-0150-5

Keywords

Mots clés

Search

Navigation