Histiocytosis in the pediatric spine: a clinical and radiographic analysis of 50 patients

Moyano, Carlos Alberto; Remondino, Rodrigo; Tello, Carlos; Piantoni, Lucas; Galaretto, Eduardo; Wilson, Ida Alejandra Francheri; Bersusky, Ernesto; Noël, Mariano A.

doi:10.1007/s43390-020-00261-8

Cited by 4 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Approximately 8 to 22% of pediatric patients with LCH have spinal involvement. Of this group, 46% have multiple spinal lesions with the cervical and thoracic spine being the most commonly involved regions 2-4 . Although LCH most commonly involves the anterior and middle elements, the posterior elements are also at risk as demonstrated in our series.…”

Section: Discussionmentioning

confidence: 99%

“…LCH of the pediatric spine frequently resolves with nonsurgical treatment 2 . Reversal of neurologic deficits and recovery of vertebral height have been demonstrated with radiotherapy, vinblastine, steroids, indomethacin, bracing, and observation alone with recurrence rates less than 20% 3,[10][11][12][13][14][15][16][17][18] .…”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Langerhans Cell Histiocytosis in the Pediatric Spine Requiring Stabilization

Englert

Daley

Metcalf

et al. 2023

JBJS Case Connector

View full text Add to dashboard Cite

Case:This report describes 3 cases of Langerhans cell histiocytosis (LCH) of the cervical and thoracic spine in patients aged 4 to 10 years. Each patient had painful lytic spinal lesions with vertebral body collapse and posterior involvement suggesting instability requiring corpectomy, grafting, and fusion. All 3 patients were doing well at their most recent follow-up without pain or recurrence.Conclusion:Although LCH of the pediatric spine is usually successfully treated non-operatively, we recommend corpectomy and fusion when there is instability of the spinal column and/or severe stenosis. Posterior element involvement occurred in all 3 cases and may lead to instability.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Langerhans Cell Histiocytosis in the Pediatric Spine Requiring Stabilization

Englert

Daley

Metcalf

et al. 2023

JBJS Case Connector

View full text Add to dashboard Cite

show abstract

“…The most common imaging characteristic of vertebral LCH besides a lytic lesion is a compression fracture with complete (vertebra plana) or incomplete vertebral body collapse [7][8][9][16][17][18][19][20][21]. Though initial lesions are typically seen on X-ray as lytic or sclerotic, further imaging via CT or MRI may show prevertebral, paravertebral, or epidural soft tissue extension.…”

Section: Imagingmentioning

confidence: 99%

Presentation, treatment, and outcomes of unifocal and multifocal osseous vertebral Langerhans cell histiocytosis lesions in patients under 18 years old

Ezeokoli

Smith

Mitchell

et al. 2023

Journal of Pediatric Orthopaedics B

View full text Add to dashboard Cite

This study aims to (1) clinically and radiographically characterize a series of unifocal (single-system singlesite) and multifocal (single-system multiple-site) langerhans cell histiocytosis (LCH) lesions in the vertebra and (2) determine the success and recurrence rates with different treatment modalities in a pediatric population at a tertiary children's hospital. Patients younger than 18 years old with a diagnosis of LCH before 1 June 2021 at our institution were reviewed. The inclusion criteria were a unifocal or multifocal vertebral lesion without systemic disease. Clinical presentations, lesion sites, radiographic findings, treatments, complications, recurrence rates, and length of follow-up were reviewed and recorded. Thirtynine patients had unifocal (36%) or multifocal (64%) vertebral lesions. 44% of patients had vertebral lesions only. The most common clinical presentation was neck or back pain (51%) and difficulty or inability to ambulate (15%). 70 vertebrae were involved in total; 59% cervical, 62% thoracic, 49% lumbar, and 10% sacral. 88% of multifocal patients underwent chemotherapy compared to 60% of unifocal patients. The recurrence rate in the entire cohort was 10%. The median length of follow-up was 5.2 years (0.6-16.8). Chemotherapy is often utilized as a treatment for vertebral LCH lesions regardless of unifocal or multifocal osseous presentation, with good outcomes and low recurrence rates. However other treatments such as observation only and steroid injections may be a better option with smaller and less widespread lesions due to side effects and length of treatment with chemotherapy. Determination of more invasive treatments including surgical excision or fixation will need to be considered on a case-by-case basis. Level of evidence: IV.

show abstract

“…It involves the axial skeleton and diaphysis long bones as well as the soft tissues adjacent to the bone causing localized bone pain and tender soft tissue swelling [4] . It has a slight male predominance most commonly affecting the children and young adults; however, it can rarely be seen in adults [5] , [6] , [7] .…”

Section: Introductionmentioning

confidence: 99%