Solitary lumbar osteochondroma presented with foot-drop: case report

Kahveci, Ramazan; Ergüngör, Mehmet Fikret; Günaydin, Ahmet; Şanlı, Ahmet Metin; Temiz, Atiye

doi:10.5137/1019-5149.jtn.3645-10.0

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Similar to the current patient, the symptoms of this patient also improved after surgical removal of the lesion. 19 In the current patient, hip flexion contracture was caused by the limited lumbar lordosis. The patient favored a kyphotic position due to the lumbar stenosis to increase the canal diameter.…”

Section: Discussionmentioning

confidence: 65%

“…18 Only 1 case of a motor deficit caused by intraspinal lumbar osteochondroma has been described; no study to date has described this phenomenon in a pediatric patient. Kahveci et al 19 described a 48year old man who had a right foot drop due to acute compression of the right L4 nerve root by a solitary lumbar osteochondroma. Similar to the current patient, the symptoms of this patient also improved after surgical removal of the lesion.…”

Section: Discussionmentioning

confidence: 99%

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Hip Flexion Contracture Caused by an Intraspinal Osteochondroma of the Lumbar Spine

Pourtaheri¹,

Emami²,

Stewart³

et al. 2014

Orthopedics

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Osteochondroma (or osteocartilaginous exostosis) is the most common bone tumor of childhood, with an incidence ranging from 1 to 1.4 per 1,000,000. In the lumbar spine, osteochondromata usually arise from the posterior column at the secondary ossification center and grow away from the spinal canal without causing neurologic deficits. This article reports a rare intraspinal lumbar osteochondroma that compressed the thecal sac, resulting in a hip flexion contracture in an 11-year-old boy. This lumbar, intraspinal, extradural exostosis was confluent with the L3 inferior articular process and compressed the L3 nerve root and thecal sac severely. The patient underwent an en bloc resection of the tumor with a right-sided hemilaminectomy of L3 and L4, a right-sided partial facetectomy at L3 to L4, and an extended resection from the pars intra-articularis of the L2 to the L5 vertebrae. The tumor specimen measured 4.8×3.7×2.5 cm with clear margins. Instrumented posterolateral fusion was completed from L2 to L5 due to iatrogenic instability from the resection. The patient had an uneventful recovery and returned to his normal activities of daily living, including sports. He remains asymptomatic at 54-month follow-up. A solitary lumbar osteochondroma that compresses the spinal cord, resulting in a motor neurological deficit, has not been reported in a pediatric patient. Orthopedic surgeons should be aware of potential intraspinal presentation of osteochondromas. Magnetic resonance imaging is the modality of choice in diagnosing and screening for spinal osteochondromas. These cases can be treated with resection surgery.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Hip Flexion Contracture Caused by an Intraspinal Osteochondroma of the Lumbar Spine

Pourtaheri¹,

Emami²,

Stewart³

et al. 2014

Orthopedics

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“…On reviewing the literature, a total of 207 articles were published from 2004 to August 2020, of which 92 articles 4 …”

Section: Discussionmentioning

confidence: 99%

Osteochondroma Arising From the Inferior Articular Process of the Lumbar Spine in a Geriatric Patient: A Case Report and Literature Review

Lin

Chen

et al. 2022

Geriatr Orthop Surg Rehabil

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Objective Spinal osteochondromas are rare, and approximately less than 5% occur as spinal lesions. We report the case of a solitary osteochondroma of the spine and review and update the literature on spinal osteochondroma, including surgical treatment and subsequent results. Case Description A 73-year-old female patient complained of a 10-year history of back pain and a 4-year history of right-side lower extremity radiating pain with paresthesia. Computed tomography and magnetic resonance imaging (MRI) revealed a bony mass arising from the inferior articular process (IAP) of L3, presenting with features of compressive spinal stenosis at the L3–L4 level. The treatment strategy included the complete marginal excision of the lesion through the posterior approach, as well as complete decompression of the spinal canal and nerve roots. The patient’s symptoms resolved after surgery, and histopathological examination identified the lesion as an osteochondroma. Review Results This review study included 168 solitary osteochondroma cases. The most commonly involved spinal level was cervical (51.8%), and the most frequent spinal anatomic column involved was the posterior column (70.8%). Radiculopathy accounted for 30.3% of all cases, myelopathy accounted for 31.0%, and 7.7% exhibited both symptoms simultaneously. The recurrence rate was 6.0%. Conclusion Computed tomography and MRI can effectively diagnose spinal osteochondroma, and surgical treatment can effectively improve clinical outcomes. In almost all symptomatic cases, the best treatment is marginal excision of the tumor. Complete resection of the cartilaginous cap of the tumor is especially important to prevent recurrence.

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“…Lesions mostly occur in the posterior arch of the vertebra with the possibility to develop within the spinal canal. They present as radiating leg pain due to nerve root compression, 3 , 4 , 9 , 10 , 12 cauda equina syndrome, 14 foot drop, 13 neurogenic claudication 11 or an atypical spinal curvature. 20 Bess et al estimated that the most common non-neurological presenting symptom for patient with lumbar osteochondroma was a palpable mass (35%) or deformity as reported in our case.…”

Section: Discussionmentioning

confidence: 99%

“…A few cases of lumbar osteochondromas expanding in the spinal canal and presenting with neurological signs have been reported in the literature. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 This is a report of an unusual case of solitary osteochondroma arising from the spinous process of the third lumbar vertebrae.…”

Section: Introductionmentioning

confidence: 96%

Solitary osteochondroma arising in lumbar spinous process: Case report

Hadhri

Tebourbi

Saidi

et al. 2016

Acta Orthopaedica et Traumatologica Turcica

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Solitary osteochondromas rarely occur in the axial skeleton. Those tumors mostly arise on the posterior elements of the cervical column causing various symptoms especially when developing within the spinal canal. Exophytic lumbar variety is uncommon presenting with palpable mass or spinal deformity. We report a 20-year-old man presenting with a solid painless mass at the lower lumbar region. Radiological examinations revealed an exophytic lesion arising in the third lumbar spinous process appearing to be a solitary osteochondroma. The lesion was treated by en-bloc resection; histopathological examination confirmed the diagnosis of osteochondroma with no evidence of recurrence at the end of 2-year follow up.

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Solitary lumbar osteochondroma presented with foot-drop: case report

Cited by 6 publications

References 13 publications

Hip Flexion Contracture Caused by an Intraspinal Osteochondroma of the Lumbar Spine

Hip Flexion Contracture Caused by an Intraspinal Osteochondroma of the Lumbar Spine

Osteochondroma Arising From the Inferior Articular Process of the Lumbar Spine in a Geriatric Patient: A Case Report and Literature Review

Solitary osteochondroma arising in lumbar spinous process: Case report

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