Abstract
Multiple hereditary osteochondromatosis is a genetically transmitted disorder consisting of multiple projections of bone capped by cartilage, which are called exosloses. Spinal cord compression due to expansion of a laminar osteochondroma is rare but well recognized. Surgical decompression usually improves the patient's neurological status but, in cervical exostosis, postlaminectomy kyphosis and instability problems, especially in the high-risk adolescent group, form the most significant potential difficulties in the postoperative period. We report a case of cervical laminar exostosis that was treated by anterior stabilization and fusion and discuss the benefits of this technique.
Key words: Cervical exostosis, Osteochondroma, Postlaminectomy kyphosis, Stabilization
Full Text
The Full Text of this article is available as a PDF (748.1 KB).
References
- 1.Albrecht S, Crutchfield JS, Segall GK. On spinal osteochondromas. J Neurosurg. 1992;77:247–252. doi: 10.3171/jns.1992.77.2.0247. [DOI] [PubMed] [Google Scholar]
- 2.Bell MS. Benign cartilaginous tumors of the spine. A report of one case together with a review of the literature. Br J Surg. 1971;58:707–711. doi: 10.1002/bjs.1800580921. [DOI] [PubMed] [Google Scholar]
- 3.Bhojraj SY, Panjwani JS. A new management approach to decompression, posterior stabilization, and fusion for cervical laminar exostosis with cord compression in a case of diaphyseal aclasis. Spine. 1993;18:1376–1379. doi: 10.1097/00007632-199308000-00021. [DOI] [PubMed] [Google Scholar]
- 4.Dahlin DC, Unni KK. Bone tumors: general aspects and data on 8542 cases. 4th edn. Springfield, Illinois: Thomas; 1986. pp. 19–22. [Google Scholar]
- 5.Emanuelson I, Kyllerman M, Roos A. Hereditary multiple exostosis with spinal cord compression in a 13-year-old boy (letter) J Neurol Neurosurg Psychiatry. 1994;57:238–239. doi: 10.1136/jnnp.57.2.238-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Ertekin A, Erdem A, Yüceer N. Osteochondroma of the upper cervical spine: a case report. Spine. 1996;21:516–518. doi: 10.1097/00007632-199602150-00021. [DOI] [PubMed] [Google Scholar]
- 7.Garrison RC, Unni KK, Leod RA, Pritchard DJ, Dahlin DC. Chondrosarcoma arising in osteochondroma. Cancer. 1982;49:1890. doi: 10.1002/1097-0142(19820501)49:9<1890::aid-cncr2820490923>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
- 8.Gottlieb A, Severi P, Ruelle A, Lasio G. Exostosis as a cause of spinal cord compression. Surg Neurol. 1986;26:581–584. doi: 10.1016/0090-3019(86)90345-9. [DOI] [PubMed] [Google Scholar]
- 9.Hudson TM, Springfield DS, Spanier SS, Enneking WF, Hamlin DJ. Benign exostosis and exostotic chondrosarcomas: evaluation of cartilage thickness by CT. Radiology. 1984;152:595–599. doi: 10.1148/radiology.152.3.6611561. [DOI] [PubMed] [Google Scholar]
- 10.Mirra JM, Picci P, Gold RH. Bone tumors. Clinical, radiological, and pathologic correlations. Philadelphia: Lea and Febiger; 1989. pp. 1626–1659. [Google Scholar]
- 11.Morard M, Preux J. Solitary osteochondroma presenting as a neck mass with spinal cord compression syndrome. Surg Neurol. 1992;37:402–405. doi: 10.1016/0090-3019(92)90012-c. [DOI] [PubMed] [Google Scholar]
- 12.Pazzaglia UE, Pedrotti L, Beluffi G. Radiographic findings in hereditary multiple exostosis and a new theory of the pathogenesis of exostosis. Pediatr Radiol. 1990;20:594–597. doi: 10.1007/BF02129063. [DOI] [PubMed] [Google Scholar]
- 13.Pecker J, Vallée B, Desplat A. L'abord interscalénique des tumeurs des trous de conjugaison cervicaux. Neurochirurgie. 1980;26:165–170. [PubMed] [Google Scholar]
- 14.Peterson HA. Multiple hereditary osteochondromata. Clin Orthop. 1989;239:22–30. [PubMed] [Google Scholar]
- 15.Resnick D. Diagnosis of bone and joint disorders, with emphasis on articular abnormalities. Philadelphia: Saunders; 1981. Additional congenital or heritable anomalies and syndromes; pp. 2548–2636. [Google Scholar]
- 16.Schajowicz F. Tumors and tumor-like lesions of bone and joints. New York: Springer; 1981. pp. 121–133. [Google Scholar]
- 17.Yablon JS. Osteochondroma of the vertebral column (letter) Neurosurgery. 1990;27:659–660. doi: 10.1097/00006123-199010000-00032. [DOI] [PubMed] [Google Scholar]