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On spinal osteochondromas.

S Albrecht1, J S Crutchfield, G K SeGall

  • 1Department of Pathology, Methodist Hospital, Baylor College of Medicine, Houston, Texas.

Journal of Neurosurgery
|August 1, 1992
PubMed
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Osteochondromas, benign bone tumors, can affect the spine, causing compression symptoms. Multiple osteochondromas present earlier and more frequently cause spinal cord compression than solitary lesions.

Area of Science:

  • Orthopedics
  • Neurosurgery
  • Oncology

Background:

  • Osteochondromas (osteocartilaginous exostoses) are common benign bone tumors, comprising 30-40% of all such lesions.
  • While often solitary, they can be multiple, frequently linked to autosomal dominant inheritance.
  • Spinal involvement occurs in 1-4% of osteochondromas, potentially leading to neurological compromise.

Observation:

  • This study reviewed five patients with spinal osteochondromas and over 130 historical cases.
  • Cases were categorized into multiple vs. solitary spinal osteochondromas.
  • A significant male predominance (2.5:1) was observed, with onset in the multiple group (mean age 21.6 years) earlier than the solitary group (mean age 30.0 years).

Findings:

  • Cervical spine involvement was common in both groups (50%).

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  • Spinal cord compression occurred significantly more often in patients with multiple osteochondromas (77%) compared to solitary lesions (33%).
  • Computerized tomography (CT) is the preferred imaging modality.

    • Implications:

    • Early diagnosis and intervention are crucial for managing spinal osteochondromas.
    • Surgical treatment yields high improvement rates (around 90%), with most patients experiencing significant recovery.
    • Understanding the distinction between solitary and multiple osteochondromas aids in predicting clinical presentation and outcomes.