Cervical Osteochondroma Causing Myelopathy in Adults: Management Considerations and Literature Review

World Neurosurg. 2017 Jan:97:752.e5-752.e13. doi: 10.1016/j.wneu.2016.10.061. Epub 2016 Oct 21.

Abstract

Background: Osteochondromas are the most frequent benign bone tumors but only rarely occur along the spinal column and even more rarely induce symptoms from spinal cord compression.

Case descriptions: We report 2 adult patients, both with a history of hereditary multiple exostoses, who presented with cervical myelopathy secondary to osteochondromas. The first patient is a 22-year-old man with numbness and weakness of his right upper limb and neck pain. Radiologic images showed a bony tumor arising from the C3 lamina with evidence of severe spinal cord compression. The second patient is a 20-year-old woman with weakness of her left upper and lower limbs and progressive numbness of the left hand, as well as neck and back pain. Radiologic images showed a bony tumor arising from the C4 lamina with evidence of significant spinal cord compression and cord signal abnormality. Both patients underwent surgical excision of the epidural mass and pathology confirmed a diagnosis of osteochondroma.

Conclusions: We discuss the role of surgical intervention, management, and postoperative follow-up in adult patients with cervical osteochondromas. Recommended management includes radiographic imaging and surgical intervention, particularly when evidence of spinal cord impingement occurs. Consistent postoperative follow-up is necessary to ensure appropriate recovery of neurologic function. Surgical management of cervical osteochondromas typically results in excellent and stable clinical outcomes with rare recurrence.

Keywords: Myelopathy; Osteochondroma; Spinal cord.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Decompression, Surgical / methods
  • Evidence-Based Medicine
  • Female
  • Humans
  • Laminectomy / methods
  • Male
  • Osteochondroma / complications
  • Osteochondroma / diagnostic imaging*
  • Osteochondroma / surgery*
  • Spinal Cord Compression / diagnostic imaging*
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / prevention & control*
  • Spinal Neoplasms / diagnostic imaging*
  • Spinal Neoplasms / etiology
  • Spinal Neoplasms / surgery*
  • Treatment Outcome
  • Young Adult