OBJECTIVE: To discuss a case of osteoid osteoma of the vertebral body with extension across the disc space, a very rare location and unique finding.

FEATURES: An 18-yr-old man suffered midthoracic pain that was thought to be related to a lifting injury. However, further evaluation revealed an osteoid osteoma of the T6 vertebral body. Special imaging revealed extension of the inflammatory component across the intervertebral disc involving the adjacent vertebral body.

INTERVENTION AND OUTCOME: The patient underwent vertebrectomy (resection of the osteoid osteoma) via a transpleural approach with T5 disc resection, sixth rib resection and rib strut graft insertion. Complete relief of the symptoms was reported almost immediately after surgery.

CONCLUSION: The vertebral body is a very unusual location for an osteoid osteoma and extension across the intervertebral disc is a unique finding. Surgical resection of the entire nidus yields optimum results.

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