Solitary thoracic osteochondroma presenting as Brown-Séquard syndrome

Ramdasi, Raghvendra; Mahore, Amit

doi:10.1136/bcr-2014-206656

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…Several other conditions less commonly contributed to the initiation of BSS, including thoracic endovascular aortic repair, spinal intramedullary cysticercosis, solitary thoracic osteochondroma, demyelinating lesion, and intramedullary meningeal melanocytoma. [46][47][48][49][50][51] In the current case, however, the development of BSS secondary to OLF was very unusual. To the best of our knowledge, only one other case of BSS secondary to OLF has been reported; this case occurred in the cervical spine in 2007.…”

Section: Discussionmentioning

confidence: 94%

Thoracic ossification of the ligamentum flavum causing Brown-Séquard syndrome: a case report and literature review

Zhang

Luo

et al. 2022

J Int Med Res

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Brown-Séquard syndrome (BSS) has many etiologies, including penetrating trauma, extramedullary tumors, and disc herniation. However, thoracic ossification of the ligamentum flavum (OLF) is an extremely rare cause of this syndrome. A 46-year-old woman with motor weakness in her right lower extremity and urinary retention was admitted to our department. Based on the results of physical examination, computed tomography, and magnetic resonance imaging, a diagnosis of BSS with OLF was considered. The patient underwent urgent conservative treatment. BSS is a rare condition characterized by hemisection or hemicompression of the spinal marrow. The herein-described case of incomplete BSS due to OLF responded to conservative treatment. However, the successful nonoperative management of this case is insufficient evidence to consider it as the standard of care. Therefore, emergency laminectomy decompression remains the standard of care for BSS.

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Section: Discussionmentioning

confidence: 94%

Thoracic ossification of the ligamentum flavum causing Brown-Séquard syndrome: a case report and literature review

Zhang

Luo

et al. 2022

J Int Med Res

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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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“…The fourth most common non-traumatic cause of BSS is tumors, which can be classified into primary and metastatic. Primary tumors include cavernous hemangioma, schwannoma, meningioma and osteochondroma [19,20]. Secondary metastasis from remote sites includes malignant mesothelioma [21], colonic carcinoma [22], squamous cell carcinoma of the maxillary sinus [23], and gastric adenocarcinoma [24], leading to intramedullary spinal cord metastasis.…”

Section: Surgically Treatable Etiologies Of Bssmentioning

confidence: 99%

Non-traumatic Causes of Brown-sequard Syndrome: A Case Series and Clinical Update With Systematic Review

2021

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Background and Importance: Brown-Sequard Syndrome (BSS) is a rare neurological condition resulting from a hemisection injury to or unilateral compression on the spinal cord. The common causes of BSS that are amenable to be treated surgically can be divided into traumatic and non-traumatic injuries. Traumatic injuries are often reported as the main cause of BSS. However, non-traumatic injuries of the spinal cord are more seen in recent years. This study aims to classify and update surgically treatable causes of BSS. Case Presentation: Retrospective data of 17 patients operated for BSS between 2008 and 2020 were included. The long-term outcomes of these patients were evaluated. In addition, a comprehensive search in PubMed, Scopus, and CINAHL was conducted for the retrieval of all relevant studies. Results: Magnetic Resonance Image (MRI) of our patients revealed Cervical Disc Herniation (CDH), spinal canal stenosis with cervical spondylosis, epidural hematoma, and ossification of the posterior longitudinal ligament. The postoperative outcomes of our cases ranged from partial to complete recovery. While the patients with acute epidural hemorrhage achieved complete recovery after surgery, neurological deficits in the other patients, especially those with severe cervical spinal canal stenosis, persisted despite adequate surgical decompression. The systematic literature review revealed that CDH is the most common non-traumatic surgically treatable cause of BSS, followed by spinal cord herniation and spinal epidural hematoma. Conclusion: Non-traumatic injuries of the spinal cord accompanied by narrowed cervical spinal canal pathologies are prominent surgically treatable causes of BSS. Contrary to the definition made 100 years ago, BSS can occur spontaneously due to underlying pathologies rather than major traumatic injuries.

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Solitary thoracic osteochondroma presenting as Brown-Séquard syndrome

Cited by 5 publications

References 16 publications

Thoracic ossification of the ligamentum flavum causing Brown-Séquard syndrome: a case report and literature review

Thoracic ossification of the ligamentum flavum causing Brown-Séquard syndrome: a case report and literature review

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

Non-traumatic Causes of Brown-sequard Syndrome: A Case Series and Clinical Update With Systematic Review

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