In a evaluation of the largest multicenter cohort of spinal osteoblastomas, local recurrence was found to be strongly associated with mortality. Application of the Enneking classification as a treatment guide for preventing local recurrence was not validated 1).

1)
Versteeg AL, Dea N, Boriani S, Varga PP, Luzzati A, Fehlings MG, Bilsky MH, Rhines LD, Reynolds JJ, Dekutoski MB, Gokaslan ZL, Germscheid NM, Fisher CG. Surgical management of spinal osteoblastomas. J Neurosurg Spine. 2017 Sep;27(3):321-327. doi: 10.3171/2017.1.SPINE16788. Epub 2017 Jul 7. PubMed PMID: 28686147.