Pediatric solitary osteochondroma of T1 vertebra causing spinal cord compression: A case report

Osteochondroma of the atlas vertebra causing high grade spinal canal stenosis: a rare case report

Osteochondromas are the most common primary benign bone tumors which can be either solitary or multiple in the form of hereditary multiple exostosis (HME). Osteochondromas are located frequently in the long bones and rarely involve the spine. Cervical spine remains the most common site for spinal osteochondroma. However, majority of the cases are neurologically asymptomatic as most of them are slow growing with growth directed outside the spinal canal. In this case report, we describe a rare case of solitary osteochondroma arising from C1 vertebra (atlas) resulting in serious neurological complications, ultimately necessitating surgical intervention.

Solitary Pediatric Osteochondroma of the Spine With Cord Compression

Osteochondromas typically arise in the appendicular skeleton, with axial lesions occurring less commonly. Osteochondroma of the spine resulting in cord compression and symptomatic myelopathy is relatively rare. Most cases are reported in adolescents and adults. Consequently, there is a scarcity of literature regarding its occurrence in the pediatric population. We report the case of a cervical osteochondroma of C4-6 with cord compression in a nine-year-old girl. Surgical excision with laminectomy and laminotomy successfully resolved all neurologic deficits. A literature review revealed 27 cases of pediatric osteochondromas with cord compression, suggesting that these lesions are not as rare in the pediatric population as previously thought.

Osteochondroma Arising From the Inferior Articular Process of the Lumbar Spine in a Geriatric Patient: A Case Report and Literature Review

Objective

Spinal osteochondromas are rare, and approximately less than 5% occur as spinal lesions. We report the case of a solitary osteochondroma of the spine and review and update the literature on spinal osteochondroma, including surgical treatment and subsequent results.

Case Description

A 73-year-old female patient complained of a 10-year history of back pain and a 4-year history of right-side lower extremity radiating pain with paresthesia. Computed tomography and magnetic resonance imaging (MRI) revealed a bony mass arising from the inferior articular process (IAP) of L3, presenting with features of compressive spinal stenosis at the L3–L4 level. The treatment strategy included the complete marginal excision of the lesion through the posterior approach, as well as complete decompression of the spinal canal and nerve roots. The patient’s symptoms resolved after surgery, and histopathological examination identified the lesion as an osteochondroma.

Review Results

This review study included 168 solitary osteochondroma cases. The most commonly involved spinal level was cervical (51.8%), and the most frequent spinal anatomic column involved was the posterior column (70.8%). Radiculopathy accounted for 30.3% of all cases, myelopathy accounted for 31.0%, and 7.7% exhibited both symptoms simultaneously. The recurrence rate was 6.0%.

Conclusion

Computed tomography and MRI can effectively diagnose spinal osteochondroma, and surgical treatment can effectively improve clinical outcomes. In almost all symptomatic cases, the best treatment is marginal excision of the tumor. Complete resection of the cartilaginous cap of the tumor is especially important to prevent recurrence.

Osteochondromas of the cervical spine-case series and review

OBJECTIVE

Cervical spine osteochondromas are rare with approximately 3% of solitary and 7-9% of hereditary osteochondromas occurring in the spine. Almost 50% of spinal osteochondromas occur in the cervical region.

METHODS

A search of osteochondroma of cervical spine was performed of our radiology database.

RESULTS

In this study, we present 11 cases of adult cervical spine osteochondromas. These predominantly involved the posterior elements. The cartilage cap was more than 2 cm in 2 cases. There was cord compression in 1 case, foraminal narrowing in 2 patients and vertebral artery compression in 1 case. 6 patients underwent excision with majority being osteochondroma. There was only one case of chondrosarcoma.

CONCLUSION

Osteochondromas of cervical spine and extremely rare and symptomatology are due to mass effect. One should be aware of this entitly when analysing cervical spine for neck pain or lump.

Solitary Osteochondroma of the Spine-A Case Series: Review of Solitary Osteochondroma With Myelopathic Symptoms

STUDY DESIGN

Case series and literature review.

OBJECTIVE

There is a growing body of literature supporting that osteochondroma of the spine may not be as rare as previously documented. The purpose of this study was to perform an updated review and present our experience with 4 cases of solitary osteochondroma of the spine, including surgical treatment and subsequent outcomes.

METHODS

A review of 4 cases and an updated literature review.

RESULTS

All 4 cases were diagnosed as solitary osteochondroma of the spine based on clinical and histopathologic findings. Majority of the lesions arose from the posterior column with one case showing extension into the middle column with clinical neurologic sequelae. Treatment strategies for all cases included complete marginal excision of the lesions using a posterior approach. All 4 cases showed no radiographic evidence of recurrence. The literature review yielded 132 cases of solitary osteochondroma and 17 case associated with multiple hereditary exostosis. Out of the 132 cases, 36 presented with myelopathic symptoms.

CONCLUSION

Osteochondroma of the spine may not be as rare as previously reported. The best approach to treatment in almost all symptomatic cases include wide surgical excision of the tumor. This should include complete resection of the cartilaginous cap of the tumor in an effort to prevent recurrence. When excision is performed properly, the outcomes are excellent with very low recurrence of the tumor.

Solitary C1 spinal osteochondroma causing vertebral artery compression and acute cerebellar infarct

Osteochondroma is a common benign bone lesion, usually involving the long bones. Spinal involvement is rare. The clinical presentation of spinal osteochondroma varies according to the site of the lesion. The most common reported clinical presentation is secondary to encroachment of the lesion on the spinal canal or nerve roots. Less common presentations such as a palpable neck mass, dysphagia, sleep apnea, paralysis of left vocal cord or acute respiratory distress have been reported when the lesions compress the anatomic structures anteriorly. We describe a rare case of a young patient who presented with an emergent critical condition of acute cerebellar infarct as a result of vertebral artery compression caused by a solitary C1 spinal osteochondroma.