Dear Colleagues
This 15 year old is suffering from pain in the back at night radiating to the rib cage for the last 9 months. He has no deficits.
MRI shows a T1 and T2 W hypo intense lesion in the T9 pedicle expanding it and enhancing with contrast. Of not is the extensive "Oedema" in the T8, T9 bodies and posterior bony elements extending to the surrounding ribs and soft tissues. A Ct guided biopsy done at another institute was reported as an osteoblastoma.
My question would be
1. Although osteoblastoma are known to have disproportionate surrounding edema, does this MRI pic fit in with osteoblastoma?
2. How would you resect this tumour?? En bloc or piece meal ?
Does it make a difference ?
3. Will you use MIS technique for this??
Eg: using a tube to resect the tumour, then packing it with some bone chips and putting percutaneous screws above and below
4. If fusing how many levels above and below?? how about T7, T8 then left T9 and upto T10.
I assume that the T8 just has reactive edema and can be used for putting pedicle screws ??