Cervical Osteochondroma Causing Myelopathy in Adults: Management Considerations 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.

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“…On reviewing the literature, a total of 207 articles were published from 2004 to August 2020, of which 92 articles 4 …”

Section: Discussionmentioning

confidence: 99%

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

Lin

Chen

et al. 2022

Geriatr Orthop Surg Rehabil

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“…[2,5] ese tumors may occur as solitary lesions, but if multiple lesions arise, they may be a manifestation of HME. [1,2,5] Solitary osteochondromas involve the spine in only 5% of cases and are most commonly found in the cervical (49%) followed by the thoracic (26%) and lumbar spine (23%). [1] Cervical lesions typically arise from C2 (24%), C1(19%), and C7 (15%).…”

Section: Frequency and Location Of Osteochondromasmentioning

confidence: 99%

“…ey may appear as solitary lesions or as multiple tumors in patients with hereditary multiple exostoses (HME). [5] upper extremity (4+/5 bicep/tricep, 4/5 wrist and handgrip) and bilateral lower extremity function remained largely intact (4+/5-5/5). e patient reported diminished sensation to light touch in bilateral hands (C6-8 dermatomes), abdomen (T4-12 dermatomes), and the left lower extremity (L2-3 dermatomes).…”

Section: Introductionmentioning

confidence: 97%

“…Osteochondromas of the cervical spine rarely contribute to spinal cord compression and resultant paresis. [2,5] Osteochondromas have a prevalence of 1 in 50,000 people, while spinal osteochondromas comprise only 5% of these. [5] ey are bony tumors capped by cartilage that mainly occur within the metaphysis and diametaphysis of long bones within the appendicular skeleton.…”

Section: Introductionmentioning

confidence: 99%

“…[2,5] Osteochondromas have a prevalence of 1 in 50,000 people, while spinal osteochondromas comprise only 5% of these. [5] ey are bony tumors capped by cartilage that mainly occur within the metaphysis and diametaphysis of long bones within the appendicular skeleton. ey may appear as solitary lesions or as multiple tumors in patients with hereditary multiple exostoses (HME).…”

Section: Introductionmentioning

confidence: 99%

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Solitary osteochondroma of the cervical spine presenting with quadriparesis and hand contracture

Milton¹,

O’Connor²,

Smitherman³

et al. 2020

Surgical Neurology International

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Background: Spinal osteochondromas are rare, benign tumors arising from the cartilaginous elements of the spine that may appear as solitary lesions versus multiple lesions in patients with hereditary multiple exostoses. Here, we present a 15-year-old female with a solitary C3-C4 osteochondroma who presented with a progressive quadriparesis and hand contracture successfully managed with a laminectomy/posterior spinal fusion. Case Description: A 15-year-old female presented with a 3-month history of progressive quadriparesis and hand contracture secondary to a magnetic resonance (MR) documented C3-C4 cervical spine osteochondroma. The MR imaging revealed a solitary osseous extramedullary outgrowth arising from the left laminar cortex of the C-3 vertebral body extending to C-4. Due to the marked resultant canal stenosis, the patient underwent a cervical laminectomy of C3- C4 with posterior spinal fusion. Gross total resection was achieved, and the pathology confirmed an osteochondroma. The patient’s myelopathy resolved, and 2 years later, she demonstrated no residual deficits or tumor recurrence. Conclusion: Here, we report the successful management of a 15-year-old female with a C3-C4 osteochondroma and progressive quadriparesis through cervical laminectomy/fusion.

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Primary and Metastatic Spine Tumors

Hitchon

Naganawa

Kim

et al. 2021

Diffusion-Weighted MR Imaging of the Brain, Head and Neck, and Spine

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Cervical Osteochondroma Causing Myelopathy in Adults: Management Considerations and Literature Review

Cited by 15 publications

References 49 publications

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

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

Solitary osteochondroma of the cervical spine presenting with quadriparesis and hand contracture

Primary and Metastatic Spine Tumors

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