Endoscopic resection for cervical and thoracic spinal osteoid osteoma: A case series

Background: Osteoid osteomas (OOs) are benign but painful bone tumors characterized by a vascularized nidus of osteoblastic cells surrounded by sclerotic bone. They affect the spine in 6%-20% of cases, most commonly in the posterior elements. Nonsteroidal anti-inflammatory drugs (NSAIDs) often provide initial relief, but surgery is required when symptoms persist. Complete nidus excision is critical to prevent recurrence. Minimally invasive techniques such as radiofrequency ablation (RFA) have gained popularity, but proximity to neural structures limits their use. Full endoscopic resection has emerged as a promising alternative, offering direct visualization, histologic confirmation, and minimal tissue disruption. This case series evaluates the safety, feasibility, and outcomes of full endoscopic resection for cervical and thoracic spinal OOs. Case Description: This retrospective series included 4 patients treated at a single academic institution between December 2023 and April 2025. Diagnosis was based on clinical and radiologic findings. All patients underwent full endoscopic resection. Postoperative outcomes were assessed using imaging. Histological confirmation was obtained in all cases. Outcome: Lesions were located at C7, T1 and T10 (2 cases). All patients reported immediate pain relief within 24 hours. No complications occurred, and all were discharged within 36 hours. Histopathology confirmed OO in every case. Follow-up imaging up to 15 months showed no recurrence. Conclusions: Full endoscopic resection of cervical and thoracic OO is safe, effective, and minimally invasive. It enables complete nidus removal, rapid symptom relief, histologic confirmation, and preservation of spinal stability. Further long-term follow-ups are warranted to validate these findings and evaluate recurrence rates.