Dr. Siddharth Katkade is a highly skilled, world wide trained and dedicated Spine Surgeon with over 10+ years of experience in field of specialised Spine Care and Orthopaedics.
- Phone:+91 88507 73095
- Email:bombayspineclinic09@gmail.com
Dr. Siddharth Katkade is a highly skilled, world wide trained and dedicated Spine Surgeon with over 10+ years of experience in field of specialised Spine Care and Orthopaedics.
Background: Gross-total excision of spinal osteoblastomas remains challenging as they are typically found in
close proximity to major neural and/or vascular structures. Here, we found that O-arm navigation allowed for
safe/effective excision of a spinal osteoblastoma in a 29-year-old male.
Case Description: A 29-year-old male presented neurologically intact with mid back pain of 8 months’ duration
and 2 months of the left-sided chest wall discomfort. X-rays showed a sclerotic left D12 pedicle, while the MRI
revealed an extradural lesion in extending into the left D11-12 neural foramen (i.e., hypointense on both T1- and
T2-weighted images). The CT scan suggested a “floating” foraminal radiolucent lesion with surrounding vertebral
body/posterior elements sclerosis and dense peripheral rim enhancement. These findings were diagnostic for an
osteoblastoma. Utilizing O-arm navigation, the nidus and full extent of the lesion were excised (i.e., utilizing
intralesional curettage). Two year’s postoperatively, there was no MR evidence of tumor recurrence.
Conclusion: O-arm navigation provided accurate intraoperative localization to safely and fully excise a left D11–
D12 spinal osteoblastoma.
Keywords: Accuracy, O-arm navigation, Safety, Spinal osteoblastoma, Various operative modalities
About 40% of all osteoblastomas are found in the spine. They mostly involve the posterior spinal elements and occur in, in descending order, the cervical, lumbar, and thoracic regions.[5] Although MR studies are often equivocal, CT examinations document the lytic/calcified nidus surrounded by a sclerotic rim, classical for osteoblastomas. Here, a 29-year-old male with a left-sided D11/D12 osteoblastoma underwent O-arm localization and safe marginal intralesional nidus resection.
A 29-year-old male presented with 8 months of mid back pain and 2 months of the left-sided chest wall discomfort with VAS 8/10. His examination revealed diffuse mid back tenderness but no neurological deficit. X-rays showed a mixed sclerotic/lytic lesion involving the left D12 pedicle and superior articular process [Figures 1a and b]. The MRI showed an extradural left-sided D11–12 foraminal lesion. It also involved the superior articular process and left pedicle of D12