Cervical spinal cord compression due to an osteochondroma in hereditary multiple exostosis: case report and review of the literature

Giudicissi-Filho, Miguel; Holanda, Carlos Vanderlei M. de; Borba, Luis A. B.; Rassi-Neto, Aziz; Ribeiro, Carlos Magno Rocha; Oliveira, Jean Gonçalves de

doi:10.1016/j.surneu.2006.05.057

Cited by 39 publications

(48 citation statements)

References 32 publications

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“…Intracanal lesions may cause pain, paresthesias, myelopathy, weakness, or gait disturbance [4,6,[8][9][10]23]. However, spinal cord compression can be difficult to detect in children.…”

Section: Discussionmentioning

confidence: 99%

Spinal stenosis frequent in children with multiple hereditary exostoses

Ashraf

Larson

Ferski

et al. 2013

Journal of Children's Orthopaedics

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Purpose Children with multiple hereditary exostoses (MHE) have numerous osteochondromas, with the most prominent lesions typically over the appendicular skeleton. A recent report noted a high rate of intracanal lesions in this patient population and recommended preventative spinal screening with magnetic resonance imaging (MRI) or computed tomography (CT). We sought to evaluate the prevalence of spinal stenosis from intracanal osteochondromas at our pediatric orthopedic center in order to evaluate if routine screening is warranted. Methods All pediatric patients treated for MHE were retrospectively identified. Records were reviewed to determine demographics, previous orthopedic surgery, and indication and results of axial spine imaging (CT or MRI).Imaging studies were reviewed to evaluate the presence of intracanal and compressive spinal lesions. Results Between 1990 and 2011, axial imaging was performed in nine patients with MHE due to concerns of pain, weakness, and/or dizziness. These patients had moderate disease involvement, with a mean of 4.9 previous orthopedic surgeries to address skeletal osteochondromas. Two patients with MHE had cervical spinal stenosis secondary to intracanal osteochondromas. Both children successfully underwent spinal decompression. Thus, of our MHE population undergoing axial imaging, 22 % were noted to have intracanal lesions. Conclusions Our experience reveals a [20 % rate of compressive intracanal osteochondromas in MHE patients undergoing spinal imaging. These two patients represent 5 % of the MHE patients treated at our center. These lesions may be slow growing, and significant consequences can occur if not identified promptly. Thus, we confer that routine axial screening of the spinal canal may be warranted in these children.

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“…Intracanal lesions may cause pain, paresthesias, myelopathy, weakness, or gait disturbance [4,6,[8][9][10]23]. However, spinal cord compression can be difficult to detect in children.…”

Section: Discussionmentioning

confidence: 99%

Spinal stenosis frequent in children with multiple hereditary exostoses

Ashraf

Larson

Ferski

et al. 2013

Journal of Children's Orthopaedics

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“…HME is a benign condition characterized by multiple cartilage-capped bony outgrowths in the metaphysis of long bone and flat bones 2,5,7) . It is a genetic disorder with an autosomal dominant pattern of inheritance 2,9) .…”

Section: Discussionmentioning

confidence: 99%

“…Malignant transformation may occur in up to 20% of patients with HME 4,10) . These exostosis, also called osteochondromas, involve the vertebral column in approximately 7-9% of cases, and 50% of these cases arise from the cervical spine 5) . Spinal cord compression resulting from HME occurs in young adults, usually in the second and third decades with male predominance 2,5,6) .…”

Section: Discussionmentioning

confidence: 99%

“…Hereditary multiple exostosis (HME) is the most common form of bone dysplasia 2,5) . It is an autosomal dominant disease with predominance in males and a benign condition characterized by presence of multiple exostosis or osteochondroma arising from long and flat bones 2,9) .…”

Section: Introductionmentioning

confidence: 99%

“…It is an autosomal dominant disease with predominance in males and a benign condition characterized by presence of multiple exostosis or osteochondroma arising from long and flat bones 2,9) . Spinal cord compression resulting from vertebral osteochondroma is a rare complication and generally becomes symptomatic during the second and third decades of life 5,7) . We report an unusual case of cervical osteochondroma presenting as Brown-Sequard syndrome (BSS) following mild trauma in a 7-year-old boy with HME.…”

Section: Introductionmentioning

confidence: 99%

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Cervical Osteochondroma Presenting as Brown-Sequard Syndrome in a Child with Hereditary Multiple Exostosis

Han

Kuh

2009

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 45 : [309][310][311] 2009 Cervical cord compression due to osteochondroma in hereditary multiple exostosis (HME) is a rare condition, especially in young children. In this report, we discuss a rare case of cervical osteochondroma presenting as Brown-Sequard syndrome (BSS) in a 7-year-old boy with HME. The child was admitted because of hemiparesis involving the right limbs and hypoesthesia on the left side following mild trauma. MR image revealed cord compression by osteochondroma of the C7 lamina. We removed the osteocondroma and the neurological deficit was improved.

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Hereditary multiple exostoses with spine involvement in a 4‐year‐old boy

Ezra¹,

Tetteh²,

Diament³

et al. 2010

American J of Med Genetics Pt A

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Hereditary multiple exostosis (HME) is an autosomal dominant disorder characterized by multiple osteochondromas. We describe a case of acute cervical spinal cord compression arising from an exostosis at the lamina of C7 and T1 in a 4-year-old Mexican-American boy with HME. His affected sibling also displayed spinal cord compression because of a bony exostosis. Acute cervical spinal cord compression resulting from osteochondroma is a serious complication of HME. (c) 2010 Wiley-Liss, Inc.

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Cervical spinal cord compression due to an osteochondroma in hereditary multiple exostosis: case report and review of the literature

Cited by 39 publications

References 32 publications

Spinal stenosis frequent in children with multiple hereditary exostoses

Spinal stenosis frequent in children with multiple hereditary exostoses

Cervical Osteochondroma Presenting as Brown-Sequard Syndrome in a Child with Hereditary Multiple Exostosis

Hereditary multiple exostoses with spine involvement in a 4‐year‐old boy

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