Staging and treatment of osteoblastoma in the mobile spine: a review of 51 cases

• Published in: European spine journal 2012-10, Vol.21 (10), p.2003-2010
• Main Authors: Boriani, Stefano, Amendola, L., Bandiera, S., Simoes, C. E., Alberghini, M., Di Fiore, M., Gasbarrini, A.
• Format: Article
• Language: English
• Subjects: Adjuvants; Adolescent; Adult; Child; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasm Staging; Neurosurgery; Original; Original Article; Orthopedic Procedures; Osteoblastoma; Osteoblastoma - mortality; Osteoblastoma - pathology; Osteoblastoma - therapy; Prognosis; Radiation; Radiotherapy; Radiotherapy, Adjuvant; Spinal Neoplasms - mortality; Spinal Neoplasms - pathology; Spinal Neoplasms - therapy; Spine; Statistical analysis; Statistics; Surgery; Surgical Orthopedics; Treatment Outcome; Young Adult
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-012-2395-8

Purpose To define the role of Enneking staging system and of the consequent different treatment options on the outcome of osteoblastoma (OBL) of the spine. Methods A retrospective review of 51 patients with OBL of the mobile spine conducted to compare the outcomes among the different types of treatments at long term follow-up (25–229 months, av.90). These 51 patients were previously staged according to Enneking staging system and treatment selected accordingly. 10 stage two (st.2) OBLs were treated with intralesional excision and 41 stage three (st.3) OBLs were treated either by intralesional excision or en bloc resection. The intralesional excision group was divided considering the use or not of radiation therapy after surgery. The recurrence rate was compared among these groups and also considering previous open surgery (“non intact” vs. “intact”). The statistical significance was defined using the Fisher Exact test. Results No local recurrence occurred in the st.2 patients treated by intralesional excision. Considering the st.3 patients, 2 local recurrences out of 13 patients occurred in the en bloc resection (15.4 %) group. All occurred in “non intact” cases (67 %). In the intralesional group, 5 local recurrences out of 27 patients occurred (18 %) being none in the group that received radiation therapy after surgery. Two occurred in the “intact” (7 %) and three in the “non intact” group (75 %). Considering all patients, the difference between the recurrence rate between “intact” and “non intact” groups was statistically significant ( p