PMC9381075_01
Nidus and surrounding bony consolidation in the anterior vertebral body observed (arrowhead) on reconstructed sagittal (A) and axial (B) computed tomography scans. (C) A short tau inversion recovery magnetic resonance image showing inflammatory changes around the nidus in the L4 vertebral body (arrow).
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However, computed tomography (CT) scans revealed a lesion with a heterogeneous enhancement pattern that was surrounded by calcification (i.e., the nidus of osteoid osteoma) in the anterior vertebral body at L4 (Fig. 1A, 1B). Sagittal short tau inversion recovery magnetic resonance images showed inflammatory changes around the tumor (Fig. 1C).
Anteroposterior (A) and lateral (B) X-ray images. Coronal and axial bone scintigraphy images (C) showing a focal accumulation of increased activity in the anterior portion of the L4 vertebral body (arrowhead).
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He did not have scoliosis (Fig. 2A, 2B). A bone scintigraphy image demonstrated a focal accumulation of increased activity in the anterior portion of the L4 vertebral body that appeared to be associated with the tumor (Fig. 2C).
Use of a computed tomography navigation system enabled accurate detection of the location of the nidus (A). Pathological findings show small osteoblasts (arrowhead) lining the margin of irregular trabecular bone (arrow), which was diagnosed as osteoid osteoma (B, scale: 50 mum).
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After reaching the anterior aspect of the L4 vertebral body via the LIF approach, the nidus was then detected under CT navigation (Fig. 3A). Pathological findings showed small osteoblasts lining the margin of irregular trabecular bone, which was then diagnosed as osteoid osteoma (Fig. 3B).
Reconstructed sagittal (A, C) and axial (B, D) computed tomography scans obtained immediately postoperatively (A, B) and 1 year after surgery confirming bony regrowth (C, D).
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Postoperative CT confirmed that the nidus had been completely resected (Fig. 4A, 4B). Approximately 1 year later, CT revealed regrowth of bone at the resection site, and the patient reported complete resolution of his back pain (Fig. 4C, 4D).