Solitary Osteochondroma of the Spine—A Case Series: Review of Solitary Osteochondroma With Myelopathic Symptoms

Abstract

Study Design:Case series and literature review.Objective:There is a growing body of literature supporting that osteochondroma of the spine may not be as rare as previously documented. The purpose of this study was to perform an updated review and present our experience with 4 cases of solitary osteochondroma of the spine, including surgical treatment and subsequent outcomes.Methods:A review of 4 cases and an updated literature review.Results:All 4 cases were diagnosed as solitary osteochondroma of the spine based on clinical and histopathologic findings. Majority of the lesions arose from the posterior column with one case showing extension into the middle column with clinical neurologic sequelae. Treatment strategies for all cases included complete marginal excision of the lesions using a posterior approach. All 4 cases showed no radiographic evidence of recurrence. The literature review yielded 132 cases of solitary osteochondroma and 17 case associated with multiple hereditary exostosis. Out of the 132 cases, 36 presented with myelopathic symptoms.Conclusion:Osteochondroma of the spine may not be as rare as previously reported. The best approach to treatment in almost all symptomatic cases include wide surgical excision of the tumor. This should include complete resection of the cartilaginous cap of the tumor in an effort to prevent recurrence. When excision is performed properly, the outcomes are excellent with very low recurrence of the tumor.

Intracanalicular Osteochondroma in the Lumbar Spine

“…The most common spinal level involved was cervical, which accounted for 63 (52.2%) of cases, followed by lumbar (n = 35, 26.5%), thoracic (n = 24, 18.2%), sacral (n = 9, 6.8%), and coccygeal (n = 1, 0.76%). 3) The most frequently involved anatomic site in the spine was the posterior column (n = 85, 64.3%), followed by unknown (n = 28, 21.2%) and the anterior column 19 (14.3%), with no cases in the middle column. 3) Kuraishi et al reported five cases of osteochondroma (OC) originating from lumbosacral spine which caused radiculopathy.…”

“…3) The most frequently involved anatomic site in the spine was the posterior column (n = 85, 64.3%), followed by unknown (n = 28, 21.2%) and the anterior column 19 (14.3%), with no cases in the middle column. 3) Kuraishi et al reported five cases of osteochondroma (OC) originating from lumbosacral spine which caused radiculopathy. 4) In both our cases, the tumor arose from the posterior column of the lumbar spine.…”

“…In a literature review of spinal osteochondroma, Yakkanti et al 3) identified 132 cases of solitary osteochondroma and 17 case associated with multiple hereditary exostoses. The average age of the patients with osteochondroma of the spine was 35.2 (range, 2-77) years.…”

“…6) Most patients with spinal osteochondroma present with neurological symptoms. In the literature review by Yakkanti et al 3) identified 104 of 132 cases of solitary spinal osteochondroma that had information available on whether or not the patients were symptomatic. Of the 104 cases, 96 were symptomatic: 39 cases presented with radiculopathy, 36 with symptoms of myelopathy, and three with symptoms of both radiculopathy and myelopathy.…”

Tinjauan Literatur : DIFERENSIASI TUMOR PRIMER TULANG BELAKANG SECARA RADIOLOGIS

“…MRI lebih baik dalam memvisualisasikan gambaran fluid-fluid level, gambaran ini dapat ditemukan pada tumor yang lain dengan area perdarahan atau nekrosis seperti teleangiektasis osteosarcoma, giant cell tumor dan chondrosarcoma, tapi sangat menyokong gambaran ABCs terutama bila didapatkan pada semua bagian lesi. 3,18…”