Osteoide osteoma of the spine and scoliosis: about 5 cases

Authors

  • Zied Jlalia Orthopedic pediatric department. Kassab institute of orthopedic surgery, Ksar Saïd 2010 Tunis
  • Zied Mansi Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital of Kairouan, Ibn Al Jazzar Street 3100 Kairouan, Tunisia
  • Bassem Guermazi Department of Orthopaedic Surgery, IBN EL JAZZAR KAIROUAN University Hospital 3100 Kairouan, Tunisia
  • Wajdi Arfa Orthopedic pediatric department. Kassab institute of orthopedic surgery, Ksar Saïd 2010 Tunis
  • Sami Bahroun Orthopedic pediatric department. Kassab institute of orthopedic surgery, Ksar Saïd 2010 Tunis
  • Atef Itifi Department of Orthopaedic Surgery, IBN EL JAZZAR KAIROUAN University Hospital 3100 Kairouan, Tunisia
  • Hedhili Guedhami Department of Orthopaedic Surgery, IBN EL JAZZAR KAIROUAN University Hospital 3100 Kairouan, Tunisia
  • Abderrahmen Souid Department of Orthopaedic Surgery, Hospital of Gafsa, Gafsa 2100, Tunisia
  • Slah Soui Department of anesthesia. IBN EL JAZZAR University Hospital, Kairouan 3100, Tunisia.
  • Bacem Zaidi Department of General Surgery, IBN EL JAZZAR University Hospital, Kairouan 3100, Tunisia
  • Samir Daghfous Orthopedic pediatric department. Kassab institute of orthopedic surgery, Ksar Saïd 2010 Tunis

DOI:

https://doi.org/10.13112/pc.1110

Keywords:

Spine; Bone Neoplasms; Osteoma, Osteoid; Magnetic Resonance Imaging

Abstract

Introduction: Scoliosis, a sideways curvature of the spine, is generally asymptomatic in children but may be associated with pain in adults. This study explores five cases of painful scoliosis caused by osteoid osteoma (OO), a benign lesion often misdiagnosed due to its rarity and subtle presentation. The aim was to examine the diagnostic challenges and treatment outcomes in cases of spinal OO presenting with scoliosis.

Methods: A retrospective study was conducted on five patients treated between 1986 and 2016, who presented with painful scoliosis attributed to OO. Radiographic imaging, including computed tomography (CT) in four cases and magnetic resonance imaging (MRI) in one case, was used for diagnosis. All patients underwent surgical resection of the OO by posterior approach with postoperative bracing. The average follow-up period was 5 years and 5 months.

Results: The average age of the patients was 12.2 years. The time to diagnosis averaged 13 months. Scoliosis was present in all cases, with two cases showing dorso-lumbar and three showing lumbar curvature. CT scans identified the OO in all patients. The lesion sites included the pedicle (2 cases: L3, L4), articular facets (1 case: L4), posterior hemi-arch (1 case: D12), and lamina (1 case: D10). Surgical resection resulted in spontaneous correction of scoliosis in three patients within an average of seven months, while one patient required additional corrective surgery due to severe scoliosis (57 °) diagnosed after 24 months. Spondylodesis with autologous bone graft was performed in two cases to ensure stability, and one patient required revision surgery due to resection at the wrong vertebral level. Postoperative bracing was used for three months in four patients. Histological analysis confirmed the diagnosis of OO in all cases. Outcomes were favorable in four patients, with resolution of pain and improved function. One case of graft nonunion occurred after revision surgery; however, the patient remained satisfied at 10 years of follow-up. The results of our series are summarized in Table 1.

Conclusion: Spinal OO should be considered in cases of painful scoliosis, especially in children. Early diagnosis through CT imaging is crucial for effective management. Surgical resection provides good outcomes, and timely intervention prevents the development of structural scoliosis.

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naslovnica Paediatria Croatica volumen 69 broj 4 2025

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Published

2025-12-16

Issue

Vol. 69 No. 4 (2025)

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Original Scientific Paper

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Copyright (c) 2025 Zied Jlalia, Zied Mansi, Bassem Guermazi, Wajdi Arfa, Sami Bahroun, Atef Itifi, Hedhili Guedhami, Abderrahmen Souid, Slah Soui, Bacem Zaidi, Samir Daghfous

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This work is licensed under a Creative Commons Attribution 4.0 International License.

By publishing in Paediatria Croatica, authors retain the copyright to their work and grant others the right to use, reproduce, and share their research articles in accordance with the Creative Commons Attribution License (CC BY 4.0), which allows others to distribute and build upon the work as long as they credit the author for the original creation.

How to Cite

Jlalia, Z., Mansi, Z., Guermazi, B., Arfa, W., Bahroun, S., Itifi, A., Guedhami, H., Souid, A. ., Soui, S., Zaidi, B., & Daghfous, S. (2025). Osteoide osteoma of the spine and scoliosis: about 5 cases. Paediatria Croatica, 69(4), 186-191. https://doi.org/10.13112/pc.1110

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