2007, Number 5
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Acta Ortop Mex 2007; 21 (5)
Lumbar osteochondroma and radicular compression. A case report
Zamudio CJE, Atlitec CP, Martínez MÓ
Language: Spanish
References: 16
Page: 261-266
PDF size: 233.36 Kb.
ABSTRACT
Most cartilage forming tumors are benign and rarely affect the spinal canal, their principal location is in humerus metaphysis, femur and tibia. They represent 2% of all tumors and 2.6% of the benign tumors of the spine, usually located at the cervical spine. It is speculated that the secondary ossification center may be aberrant cartilaginous tissue that causes the formation of osteochondroma. From 1 to 4% of osteochondromas involve the spine and are commonly included in the posterior elements of the vertebrae and if located near neurological structures causing irritation and spinal compression is rare but potentially catastrophic. The average age of clinical onset is at the 2nd and 3rd decade of life. Case presentation: 50-year-old male who began his illness four years ago with pain in the lumbar region with right leg paresthesias, muscle strength 4/5 in the dermatomes L4 and L5, pain was increasing in intensity and frequently. The complete cure was to remove the exostosis of the lamina of right side of L4 with projection to the medullary canal and origin of the contact with the root of L4. We performed: clinical history, physical examination, x-rays, magnetic resonance imaging, electromyography, histology. It was performed: total removal of the tumor effectively and symptoms disappeared. As the spinal osteochondromas are rare and tend to occur in young adults.
REFERENCES
Gaetani P, Tancioni F, Merlo P, Villani L, Spanu G, Baena R: Spinal chondroma of the lumbar tract: case report. Surg Neurol 1996; 46(6): 543-9.
Gurkanlard, Aciduman A, Gunaydin A, Kocak H, Celik N: Solitary intraspinal lumbar vertebral osteochondroma: a case report. J Clin Neurosci 2004; 11(8): 911-3.
Sakai D, Mochida J, Toh E, Nombra T: Spinal osteochondromas in middle-aged to elderly patients. Spine 2002; 27(23): E503-6.
Lee PC, Chen WJ, Tu YK, Chen LH: Solitary osteochondroma of the lumbar spine with cord compression: a case report. Changgeng Yi Xue za Zhi 1998; 21(2): 227-31.
Fiechtl JF, Masonis JL, Frick SL: Spinal osteochondroma presenting as atypical spinal curvature: a case report. Spine 2003; 28(13): 252-5.
Hickey CH: Osteochondroma of the vertebra. Henry Ford Hosp Med J 1969; 17(1): 53-8.
Fiumara E, Scarabino T, Guglielmi G, Bisceglia M, D’Angelo V: Osteochondroma of the L-5 vertebra: a rare cause of sciatic pain. Case report. J Neurosurg 1999; 91(2 Suppl): 219-22.
Esposito PW, Crawford AH, Vogler C: Solitary osteochondroma occurring on the transverse process of the lumbar spine. A case report. Spine 1985; 10(4): 398-400.
Malat J, Virapongse C, Levine A: Solitary osteochondroma of the spine. Spine 1986; 11(6): 625-8.
Spaziante R: Osteochondroma of the spine. Neurosurgery 1991; 28(6): 931-2.
Spaziante R, Irace C, Gambardella A, Cappabianca P, De Divitiis E: Solitary osteochondroma of the pedicle of l4 causing root compression. Case report. J Neurosurg SCI 1988; 32(4): 141-5.
Ohtori S, Yamagata M, Hanaoka E, Suzuki H, Takahashi K, Sameda H, Moriya H: Osteochondroma in the lumbar spinal canal causing sciatic pain: report of two cases. J Orthop Sci 2003; 8(1): 112-5.
Royster RM, Kujawa P, Dryer RF: Multilevel osteochondroma of the lumbar spine presenting as spinal stenosis. Spine 1991; 16(8): 992-3.
Ven Der S, Luis R, Gurr K, Joseph MG: Osteochondroma of the lumbar spine. An unusual cause of sciatica. Spine 1992; 17(12): 1519-21.
Von Torklus, Braband H: Cartilaginous exostoses of the small vertebral joints in the lumbar area. Fortschr Geb Rontgenstr Nuklearmed 1963; 99: 682-4.
Mermer MJ, Gupta MC, Salamon PB, Benson DR: Thoracic vertebral body exostosis as a cause of myelopathy in a patient with hereditary multiple exostosis. J Spinal Disorders Tech 2002; 15(2): 144-8.