Best Way to Treat Osteoblastoma of the Cervical Spine

Osteoblastoma is a typically benign bone cancer most common in adults younger than 30 years old. It affects the spine in about 40 per cent of all cases. In this article, surgeons review surgical treatment for this problem in the cervical spine (neck).

Even with careful removal of the tumor, they often grow back. Their presence so close to vital blood vessels and the spinal cord make treatment of this problem very complex.

The exact type of surgery depends on the tumor size and location. In this study, one surgeon performed a surgical procedure in each of nine patients with cervical osteoblastoma. Embolization (either partial or complete) was done first before surgery.

Embolization is a non-surgical, minimally-invasive procedure using metal sponges or other devices to purposefully block blood flow. Surgery to remove the tumor was then done within 24 hours of the embolization.

In each case, the tumor and a small margin of normal tissue around each tumor was removed. This is called marginal resection. Fusion of the bones was done when necessary. Methods of fusion used were described. In one case a larger amount of tissue was removed due to the location of the tumor.

Results of surgery were measured by assessing pain, neurologic symptoms, and whether or not the tumor came back. X-rays, CT scans, and MRI were used to diagnose and follow each case closely.

There was no recurrence of tumor in any of these patients. The authors suggest that preoperative embolization helps make removal of tumors easier. The small number of patients in the study prevented them from recommending this preoperative treatment routinely. But their work so far supports the use of preoperative embolization combined with tumor-free margin resection to prevent tumor recurrence.