Surgical treatment of symptomatic osteochondroma

Böttner, Friedrich; Rödl, Robert; Kordish, Igor; Winklemann, W; Gosheger, Georg; Lindner, Norbert

doi:10.1302/0301-620x.85b8.14059

Cited by 103 publications

(107 citation statements)

References 24 publications

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“…Surgery is the treatment of choice when there are neurologic complications other than pain. 2,28 Although the midscapular mass was palpable in this patient, lesions may be obscured by obesity or may reside in regions of the skeleton that are difficult to palpate. Because adolescent and adult obesity has increased rapidly in the United States and most osteochondromas are diagnosed by the age of 12 years, lesions in adults may go unnoticed.…”

Section: Discussionmentioning

confidence: 77%

“…Complications are found more often in patients with multiple lesions than in those with a solitary osteochondroma. 2,3 Solitary osteochondromas are found in the spine 1% to 4% of the time, whereas spinal occurrence is seen in 7% to 9% of patients with HME. 9 Patients with vertebral osteochondromas associated with HME present with spinal cord compression 96% of the time.…”

Section: Discussionmentioning

confidence: 99%

“…Many osteochondromas are asymptomatic; however, complications can involve bone, nerve, and soft tissues via mass effect or intrinsic change [1][2][3][4][5][6][7][8][9][10] (Fig 1).…”

Section: Introductionmentioning

confidence: 99%

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Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Zoboski

2017

Journal of Chiropractic Medicine

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Objective: The purpose of this report was to describe the presentation of a patient with hereditary multiple exostoses and thoracic spinal cord compression from an osteochondroma. Clinical Features: A 31-year-old female presented to a chiropractic clinic with a history of hereditary multiple exostoses and back pain that had existed since the age of 16 years. She had a past medical history that was remarkable for 3 prior surgeries for mass removal. Examination revealed a left upper midscapular mass with decreased sensation. Intervention/Outcome: Magnetic resonance imaging, computed tomography, and biopsy led to a diagnosis of osteochondroma. These diagnostic modalities confirmed that there was no malignant degeneration. Initial magnetic resonance imaging revealed a large expansive lesion involving the left posterior elements at the region of T3-T4. Subsequent thoracic hemilaminectomy and resection of the spinal tumor with posterior instrumentation and stabilization from T2-T5 resulted in 90% overall subjective improvement. Conclusions: A detailed case history, thorough examination, guided advanced imaging, and biopsy provide important information for the diagnosis and appropriate treatment of expansive lesions in patients with hereditary multiple exostoses. (J Chiropr Med 2017;16:72-77)

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Zoboski

2017

Journal of Chiropractic Medicine

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“…Considering that 11.6% of the patients were not fully satisfied with the surgery and that 4.7% would not have surgery again, we see no justification for the prophylactic excision of asymptomatic osteochondromas. 5 Surgical indications are pain, disturbance of growth, decreased range of movement, bursitis, peduncle fractures and symptoms secondary to compression of peripheral neuro vascular structures. Major complications and local recurrence are rare.…”

Section: Discussionmentioning

confidence: 99%

Osteochondroma Talus: A Case Report

Krishna¹,

Kumar²,

Rambabu³

et al. 2015

jemds

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“…However, there are a number of reasons why surgery may be performed, including pain, inhibited growth, decreased range of motion, cosmesis, peripheral nerve compression, vessel compression and to reduce the risk of a malignant transformation, with pain being the most common (1,2). The recommended surgical intervention in these instances is the resection of the tumor (3). Numerous studies have focused on exposing the hip joint capsule or the femur neck, as tumors located in these areas more commonly lead to clinical symptoms and severe complications (4,5).…”

Section: Introductionmentioning

confidence: 99%

A novel surgical approach for the treatment of tumors in the lesser trochanter

Sun

Song

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The proximal femur is a common location for the development of primary benign bone tumors. However, there is currently no surgical technique designed specifically for treating tumors located in the lesser trochanter. In the present study, a novel procedure was developed for directly exposing the lesser trochanter for surgical intervention. This technique may be particularly suited to treating tumors that extend toward the lateral and anterior forward of the lesser trochanter. The new approach involved passing through the femoral triangle, separating the femoral nerve and femoral vessels (artery and vein) and resecting the tumor between the iliopsoas and pectineal muscles. The procedure was performed on six patients with various types of tumor, including one case with osteoid osteoma, one case with non-osteogenic fibroma, one case with osteoma, one case with liposarcoma and two cases of osteochondroma. The preliminary results indicated that the surgical durations were short (60-100 min), blood loss was minimal (30-200 ml) and that pain relief was achieved following surgery. Only one patient continued to experience mild pain, scoring 18 mm on a visual analog scale. The other patients were fully relieved of pain. Sensory dysfunction was experienced by one patient following surgery, with persistent numbness and paresthesias in the distribution of the femoral nerve. No cases of deep vein thrombosis, femur head necrosis, hip joint degeneration disease or local recurrence were identified in any patients during the follow-up period. In order to clarify the virtual tissue, such vessels, nerves and the available space in our approach area, we collected 20 cadaveric specimens and performed anatomical examinations in and around the formal triangle. The spaces between the femoral artery and femoral nerve were measured and analyzed, with the results demonstrating that a definite space existed. Therefore, the novel approach presented in the study may be useful in the resection of benign tumors and the preoperative palliative resection of malignant tumors. The technique may be particularly suited to tumors extending toward the lateral and anterior of the lesser trochanter.

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Surgical treatment of symptomatic osteochondroma

Cited by 103 publications

References 24 publications

Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Osteochondroma Talus: A Case Report

A novel surgical approach for the treatment of tumors in the lesser trochanter

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