Operative and non-operative options for benign primary spine tumors

Benign primary spinal tumors (BPST) are rare entities with significant diagnostic and therapeutic challenges. These tumors can originate from the various mesenchymal tissues that compose the spinal column. They are typically classified using the Enneking or Weinstein-Boriani-Biagini (WBB) classifications, which guide surgical planning and intervention. The most frequent benign spinal tumors include osteoblastoma, osteoid osteoma, osteochondroma, giant cell tumors, aneurysmal bone cysts, hemangiomas, and Langerhans cell histiocytosis. Treatment options vary from nonoperative therapies such as analgesics, radiotherapy, and tumor ablation, to surgical interventions ranging from intralesional curettage to en bloc resection. The choice of treatment depends on factors such as tumor type, location, and potential for recurrence. A multidisciplinary approach, involving orthopedic surgeons, oncologists, and radiologists, is crucial for optimizing patient care. This review aims to provide concise information for the operative and nonoperative treatments of the most common extramedullary primary benign spinal tumors.