Osteochondroma of The Spine: a Rare Case Report

Abstract

Introduction: Osteochondroma is the most common benign bone tumor, accounting for 36% of benign bone tumors. Most commonly found in long bones, reports show that spinal osteochondroma is relatively rare, accounting for only 4% to 7% of primary benign spinal tumors.Case Report: A 29-year-old man came to the outpatient polyclinic of Haji Adam Malik General Hospital Medan with complaints of weakness in the lower limbs since 2013. The patient had a history of trauma in which he was hit by a pedicab in September 2012, Physical examination of the local status of the rear area shows that on inspection abnormal bony prominence was found, on palpation a palpable mass was found on the lumbar area sized 2 x 2 cm, and limited range of motion of the thoracolumbar area due to weakness. Whole Spine MRI without contrast showed straight thoracolumbar and degenerative marrow disease with bulging of L4-5 and L5-S1 discs pressing against the spinal canal. Mass on the right side of Th 11 to L1 involving the right multifidus lumborum muscle and right longissimus thoracis muscle, attached to the arch up to the spinous process compresses the spinal canal and the right side of the neural foramen. TREATMENT: The treatment of this patient is an open biopsy, tumor excision, Th10-12 laminectomy, and Th9-Th10-L1 posterior stabilization.Discussion: Total tumor resection is recommended for neurological repair and to reduce the risk of malignant transformation, although the risk of malignant transformation remains low. Spinal fusion and posterior instrumentation may be required to prevent spinal instability after extensive laminectomy in surgical procedures. In this case, the fusion procedure is performed and showed excellent clinical outcome after total resection of spinal osteochondromas. In this patient, there was no significant motor improvement, but sensory improvement was found at right and left L3 levels compared to the preoperative baseline. Conclusion:Patients with spinal osteochondroma are rare cases. MRI and biopsy are tests that can be used to confirm the diagnosis. The best approach to this treatment is excision of the tumor. Careful surgical excision with complete resection is important to prevent recurrence.