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Osteoid Osteoma of the Lumbar SpineA Case Report Highlighting a Novel Reconstruction Technique
Brett D. Crist, MD1; Lawrence G. Lenke, MD1; Stephen Lewis, MD1
1 Department of Orthopaedic Surgery, One Barnes-Jewish Plaza, Suite 11300 West Pavilion, St. Louis, MO 63110. E-mail address for L.G. Lenke: lenkel@wustl.edu
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at St. Louis Shriners Hospital, St. Louis, Missouri

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Feb 01;87(2):414-415. doi: 10.2106/JBJS.C.01499
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Osteoid osteomas are rare, benign tumors. They are differentiated from osteoblastomas by their size. McLeod et al. defined lesions with a diameter of =1.5 cm as osteoid osteomas and those with a diameter of >1.5 cm as osteoblastomas1. Approximately 20% of osteoid osteomas occur in the spine, and most involve the posterior elements2,3. Ten percent of those in the spine occur in the vertebral body4. The lumbar spine is the most commonly involved segment3,4. The rate of associated compensatory scoliosis has been reported to be as high as 74%; Heiman et al. reported that seventeen (74%) of twenty-three patients with osteoid osteomas or osteoblastomas had a spinal deformity4. The tumor typically is located at or near the concave apex of the curve5,6. If the fourth or fifth lumbar vertebra is involved, the apex is typically cephalad to the lesion and pelvic obliquity is present5. Asymmetric pain-provoked muscle spasm on the side of the lesion is thought to be the cause of the scoliosis6. Ransford et al. postulated that the concave-side muscle spasms, if present for long enough, eventually will cause asymmetric growth inhibition of the vertebral epiphysis, leading to a rotational deformity and making the curve more structural7.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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