Navigation assisted tubular resection of lumbar osteoid osteoma: how I do it.

Abstract

Osteoid osteoma is a benign primary bony tumor involving the spinal posterior arches. Surgical treatment is reserved to patients with severe pain or not responding to nonsteroidal anti-inflammatory medications. We report a minimally invasive transmuscular resection of an L5 isthmic osteoid osteoma, assisted by intraoperative 3D-fluoroscopy-based navigation. Navigation tracking reference is placed on the spinous process. A simil-scan with 3D-fluoroscopy is obtained to allow autoregistration for spinal navigation. Tubular transmuscular approach, directed to the ipsilateral isthmus and pedicle, is performed. Under navigation guidance, the lesion is identified and removed. This technique is a safe and effective minimally invasive alternative to conventional surgical treatment of lumbar osteoid osteoma.