Osteoid osteoma or osteoblastoma of the cervical spine in relation to the vertebral artery

Osteoid osteoma or osteoblastoma of the cervical spine require complex therapeutic solutions in cases in which there is proximity to the vertebral artery. We describe four such cases. Generally, resection was efficacious and without recurrence, but twice the vertebral artery had to be sacrificed. Although we did not find any serious neurological complication, we concluded that a simple sacrifice of one of the vertebral arteries is not acceptable, principally because of the importance and variability of the unknown radiculomedullary branches of the vertebral artery. We discuss the therapeutic strategies for treating these lesions, namely preoperative investigations, surgical approaches, and vascular control