Cervical osteochondroma: surgical planning

Fowler, James B.; Takayanagi, Ariel; Siddiqi, Imran; Ghanchi, Hammad; Siddiqi, Javed; Veeravagu, Anand; Desai, Atman; Vrionis, Frank D.; Hariri, Omid R.

doi:10.1038/s41394-020-0292-7

Cited by 9 publications

(13 citation statements)

References 27 publications

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“…The diagnosis can be made clinically and radiographically, and it can be confirmed using genetic testing. The average age of diagnosis is 30 years, usually earlier in cases of MHE 4 . The patient presented had a high clinical suspicion for osteochondroma as a cause of cervical pain because of his positive history of MHE.…”

Section: Discussionmentioning

confidence: 99%

“…Most spinal osteochondromas (50%-58%) are found in the cervical spine, 4 and C2 is usually the most affected level 8 , probably due to higher mobility of the upper cervical segment. However, Fowler et al 8 found in a meta-analysis that in cases of solitary exostosis, the most common level was C5.…”

Section: Discussionmentioning

confidence: 99%

“…It represents the most common bone tumor and may occur as a form of solitary exostosis or as part of autosomal dominant disorder known as Multiple Hereditary Exostoses (MHE) 2 . Involvement of the spine occurs in 1% to 9% of the patients 3 but may be underreported as they are usually asymptomatic 4 .…”

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confidence: 99%

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Medullary Compression by a Cervical Osteochondroma in a Patient with Multiple Hereditary Exostoses

Lixa,

Pinho,

Vieira

et al. 2023

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Case: A 19-year-old man with Multiple Hereditary Exostoses presented with cervical pain without neurological symptoms and/or signs. Magnetic resonance revealed a large C2 osteochondroma, occupying a part of the medullary canal. He was submitted to an en bloc resection with hemilaminectomy without fusion. At the 1-year follow-up, he presented resolution of pain and no neurological symptoms or signs, without cervical instability or radiological signs of disease recurrence. Conclusion: Cervical osteochondroma is usually asymptomatic. Neurological compression and differentiation to chondrosarcoma are the main concerns. Surgical excision allows the local cure of the disease and is usually performed without fusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Medullary Compression by a Cervical Osteochondroma in a Patient with Multiple Hereditary Exostoses

Lixa,

Pinho,

Vieira

et al. 2023

JBJS Case Connector

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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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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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“…X-ray assessment is usually used to diagnose osteochondroma in the extremities, whereas X-ray diagnosis of osteochondroma in the spine is more difficult.Some scholars believe that only 21% of osteochondromas of the spine can be diagnosed by X-ray film [6].X-rays do not provide much information about the relationship between the tumor and other structures.The lesion can only be shown on X-ray film with or without pedicled, the width of the base, whether the medullary cavity of the lesion is connected with the medullary cavity of bone, etc.Therefore, it is necessary to use CT and MRI to evaluate osteochondroma of the spine.CT or MRI can show the neural structure, spinal cord or nerve root compression and the relationship between the mass and surrounding tissues [13].In particular, MRI can assess the thickness of the cartilage cap, which is difficult to see on conventional radiographs. Therefore, CT and MRI are considered the most appropriate methods for the detection and evaluation of spinal osteochondroma disease [6,13,14].Osteochondroma should be highly suspected if imaging shows pedicled or unpedicled bony prominences, cortical and cancellous tissue attached to normal bone, and transparent cartilaginous shadows of irregular calcification and/or ossification at the apex. In addition, if there are cortical irregularities, popcorn calcification and increased cartilage cap thickness in the imaging examination, it should be highly suspected as malignant.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic features of lumbar canal osteochondroma and review of literature

2022

FMSR

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Osteochondroma is a common benign primary bone tumor that can be multiple or solitary and is usually caused by a developmental defect in the growth plate. Osteochondroma usually arises from an osteochondroma near the ends of long bones and is less likely to occur in the spine. Data show that the incidence of single spinal osteochondroma is only 1.3%-4%, and the most common sites are cervical vertebra, thoracic vertebra, thoracolumbar and lumbar vertebra. Osteochondroma of the lumbar spine is rare because its ossification center generally ossified around 30 years of age, later than cervical and thoracic vertebrae. Only about 30% of patients with osteochondroma of the lumbar spine had intact cartilage caps. If the thickness of the cartilage cap is assessed, it is difficult to see on conventional radiographs. Conventional radiographic assessment is usually used to diagnose osteochondroma in the extremities, whereas radiographic diagnosis of osteochondroma in the spine is more difficult. This case was reported as a female patient with a single osteochondroma, which occurred in the lumbar spine and had a complete cartilage cap during the operation. This case is rare, which can provide some help for clinical practice to avoid misdiagnosis and missed treatment of this kind of disease.

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Cervical osteochondroma: surgical planning

Cited by 9 publications

References 27 publications

Medullary Compression by a Cervical Osteochondroma in a Patient with Multiple Hereditary Exostoses

Medullary Compression by a Cervical Osteochondroma in a Patient with Multiple Hereditary Exostoses

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

Diagnostic features of lumbar canal osteochondroma and review of literature

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