Spinal Melorheostosis: A Rare Cause for Thoracic Radiculopathy

Renjith, Karukayil Ramakrishnan; Shetty, Ajoy Prasad; P, Rishi Mukesh Kanna; Rajasekaran, S.

doi:10.14444/7027

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…There are 6 reported cases of surgical treatment of spinal melorheostosis 15 . In these patients, because of the symptoms of myelopathy or radiculopathy, spinal fusion surgery was performed in addition to decompression in 4 of them while only decompression was performed in 2 of them, and the results of surgical treatment were reported to be satisfactory in cases where conservative treatment failed 15 . Recurrence was reported in only 1 of the patients who underwent surgical treatment, and it was reported that decompression was applied again because of neurological worsening 16 .…”

Section: Discussionmentioning

confidence: 99%

Spinal Melorheostosis

Serttas,

Saglam,

Kochai

et al. 2023

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Case: A 22-year-old female patient was referred to the orthopaedic department for further examination after a radiopaque area was observed in the T6 vertebra in her chest radiograph. Computed Tomography (CT) showed a sclerotic mass with smooth borders, involving the entire body of the T6 vertebra, left posterior elements, posterior of the rib past the left zygapophyseal joint, and a “flowing candle wax” image toward the T7 vertebra. Spinal melorheostosis was considered radiologically in the patient, but malignancy could not be completely excluded. Thereupon, open biopsy was performed under general anesthesia. Conclusion: Spinal melorheostosis is a rare condition. Histological examination should be considered in cases where the diagnosis remains suspicious after clinical and radiological evaluations.

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Section: Discussionmentioning

confidence: 99%

Spinal Melorheostosis

Serttas,

Saglam,

Kochai

et al. 2023

JBJS Case Connector

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“…7 8 Cases with myelopathic symptoms secondary to the spinal cord or nerve root compression by hyperostotic bone in melorheostosis have been reported. 9 10 11 12 13 14 …”

Section: Discussionmentioning

confidence: 99%

Spinal Melorheostosis Associated with Intradural Fibrous Band and Extensive Lipomatosis Causing Thoracic Cord Tethering and Myelomalacia: A Unique Case Highlighting Importance of MRI in Management

Dhanokar

Thippeswamy

Shetty

et al. 2022

Indian J Radiol Imaging

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Axial melorheostosis is rare with only few cases reported and even fewer with symptoms. While symptoms secondary to neural foramen or spinal canal stenosis caused by hyperostotic bone are common, only three symptomatic cases of spinal melorheostosis with associated intradural lipomatous lesions have been reported to date. In none of them the fibrous component of lipofibromatous lesion was identified preoperatively on magnetic resonance imaging. We report here a case of 18-year-old male who presented with thoracic myelopathy secondary to widespread spinal melorheostosis associated with extensive intradural lipomatosis and fibrous component in thoracic lipoma, causing tethering of thoracic spinal cord and myelomalacia. The patient was treated with T2 to T9 posterior instrumented stabilization followed by T3 to T8 laminectomy along with selective thoracic lipofibromatous tumor debulking. Detection of the fibromatous component in multilevel extensive intradural lipomatosis associated with melorheostosis is helpful in planning selection of the level of surgical excision and decompression.

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“…In addition to the above symptoms, some patients also have root compression. However, separate nerve root stimulation is rarely observed [ 6 ]. Once the spinal cord is compressed by TOLF, the conservative treatment effect is poor, and surgery is the only effective method.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Poor Outcomes of Thoracic Ossification of Ligamentum Flavum After Laminectomy

Sun

Shen

2022

Med Sci Monit

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Background Thoracic ossification of ligamentum flavum (TOLF) is a common pathological change of the thoracic ligamentum flavum. Identifying the risk factors for poor prognosis is critical for choosing suitable surgical methods. Material/Methods A total of 64 patients with TOLF after laminectomy were reviewed between January 2010 and April 2018 at the Department of Spine Surgery of the Third Hospital of Hebei Medical University. The Japanese Orthopaedic Association (JOA) scale was used to evaluate the neurological function of patients. According to the average JOA improvement rate, the patients were divided into the good prognosis group (Group GP) and the poor prognosis group (Group PP). Multivariate logistic regression analysis was used to identify the risk factors for poor outcomes. Results The average JOA improvement rate was 53.04±24.29%. Group GP comprised 33 patients, while Group PP comprised 31 patients. Duration of preoperative symptoms ( P =0.005), intramedullary high signal intensity ( P =0.001), dural ossification rate ( P =0.002), and sagittal configuration of ossification ( P =0.012) were significantly higher in Group PP than in Group GP. Multivariate logistic analysis showed that duration of preoperative symptoms ( P =0.022), intramedullary high signal intensity ( P =0.010), dural ossification ( P =0.007) and sagittal configuration of ossification ( P =0.029) were risk factors for poor outcomes of TOLF after laminectomy. Conclusions After surgical treatment of TOLF, the symptoms of some patients either recovered slowly or did not recover. Longer than 17 months of preoperative symptoms, intramedullary high signal intensity, dural ossification, and sagittal configuration of ossification were the risk factors for poor outcomes of TOLF after laminectomy.

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Spinal Melorheostosis: A Rare Cause for Thoracic Radiculopathy

Cited by 5 publications

References 13 publications

Spinal Melorheostosis

Spinal Melorheostosis

Spinal Melorheostosis Associated with Intradural Fibrous Band and Extensive Lipomatosis Causing Thoracic Cord Tethering and Myelomalacia: A Unique Case Highlighting Importance of MRI in Management

Risk Factors for Poor Outcomes of Thoracic Ossification of Ligamentum Flavum After Laminectomy

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