Osteoid osteoma of a vertebral body: report of a case with extension across the intervertebral disk.

An 18-year-old woman was evaluated for aching mid thoracid back pain of 4 years' duration. At 13 degrees left thoracic scoliosis was noted in association with a sclerotic process involving the inferior portion of the vertebral body of T7 and the superior margin of T8 across a well maintained disk space. Open biopsy confirmed the impression of a nidus in the body of T7 which was histologically consistent with osteoid osteoma. The disk space was well maintained and the sclerotic changes in the superior margin of T8 appeared to represent reactive change. Postoperative relief of back pain was complete. The occurrence of reactive bone across an intact disk space in response to an osteoid osteoma nidus is unique to this case. Osteoid osteoma should be included in the differential diagnosis of chronic spine pain and reactive changes secondary to irritant property of the nidus may be widespread.