[Lumbar osteochondroma and radicular compression. A case report]

Area of Science:

• Orthopedic Oncology
• Neurosurgery
• Spinal Tumors

Background:

• Osteochondromas are benign cartilage-forming tumors, typically found in long bone metaphyses.
• Spinal involvement is rare (1-4% of osteochondromas), often affecting posterior vertebral elements.
• These tumors can cause neurological compromise if near neural structures.

Observation:

• A 50-year-old male presented with four years of progressive lumbar pain and right leg paresthesias.
• Physical examination revealed motor deficits (4/5 strength) in L4 and L5 dermatomes.
• Imaging (X-ray, MRI) and electrodiagnostic studies confirmed an osteochondroma of the L4 lamina impinging on the medullary canal and L4 nerve root.

Findings:

• Surgical excision of the L4 vertebral osteochondroma was performed.
• Histological examination confirmed the benign nature of the tumor.
• Complete symptom resolution was achieved post-operatively.

Implications:

• This case highlights the importance of considering osteochondromas in the differential diagnosis of spinal tumors, even in older adults.
• Surgical management can be curative for symptomatic spinal osteochondromas.
• Early diagnosis and intervention are crucial to prevent irreversible neurological damage.