Diaphyseal aclasis with spinal cord compression

Abstract

In diaphyseal aclasis, the exostoses usually involve long bones, although occasionally the spine is also affected. Very few cases of osteochondroma causing spinal cord compression have been cited. The authors report their experience with two cases of diaphyseal aclasis. In the first case spinal cord compression caused by an exostosis of the lamina of C-2 occurred in a 9-year-old boy; in the second case a large osteochondroma of C-5 occurred in a 45- year-old man. Also included in this report is a review of the literature highlighting the incidence of diaphyseal aclasis, its clinical features and its excellent prognosis in treated cases.

Solitary Osteochondroma Arising from Cervical Spina Bifida Occulta

“…The most common symptoms are radiating pain, motor deficits, sensory disturbances, and urinary incontinence [3]. The clinical signs and symptoms appear in second and third decades of life, with an average age of 20 at the time of diagnosis [13, 14]. In our case, the solitary osteochondroma arose from the right posterior element of C5 vertebra and from the bifid lamina, and it caused compressive radicular symptoms in the right upper extremity.…”

“…However, postlaminectomy kyphosis can be seen. Therefore, laminectomy should be minimized to prevent this, especially in young patients like our patient [14]. In our case, we surgically removed the lesion totally with right hemilaminectomy and the complaints of the patient due to the tumor gradually decreased and disappeared just after the surgery.…”

Myelopathy and Quadriparesis due to Spinal Cord Compression of C1 Laminar Osteochondroma

“…Approximately 1-4% of them occur in the spine [3]. Development in conjunction with HME, which is most often inherited as an autosomal dominant trait, is more frequent and has been reviewed thoroughly [2]. The solitary and multiple forms are detected in males more frequently than in females with a ratio of 1.8:1 (multiple) to 3:1 solitary [3].…”

“…Clinical manifestations in previously reported HME cases are in the second or third decades of life with a median age of 20 years [2]. An increased incidence of spinal cord compression has been reported in HME cases when compared to the solitary ones [3].…”

“…HME has a higher incidence of spinal involvement (3% of cases) and neurological complications than the solitary variety. The occurrence of osteochondromas, particularly in cases of HME, is generally in young adults with most cases becoming symptomatic during the second and third decades of life [2]. The progression of these symptoms has been associated with continued bone growth.…”