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Giant thoracic osteophyte: a distinct clinical entity.

Jean-Valery C E Coumans1, Jonathan B Neal1, Brian E Grottkau2

  • 1Department of Neurosurgery, Massachusetts General Hospital & Harvard Medical School, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|May 20, 2014
PubMed
Summary

Giant thoracic osteophytes are rare calcified lesions in the thoracic spine causing spinal cord compression. Surgical resection is the primary treatment to alleviate symptoms.

Keywords:
ArthrodesisDegenerative diseaseFusionMyelopathyOsteophyteSpineThoracic

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Radiology

Background:

  • Calcified lesions in the neural axis include ossification of the posterior longitudinal ligament, diffuse idiopathic skeletal hyperostosis, and ossification of the ligamentum flavum.
  • Differentiating these from other calcified lesions is crucial for accurate diagnosis and treatment.

Observation:

  • Four patients presented with unusual calcified lesions in the ventral spinal canal.
  • These lesions were isolated, large calcific masses originating from the posterior aspect of thoracic vertebral bodies.
  • Pathological examination ruled out tumor as the cause.

Findings:

  • Disc volumetrics differentiated giant thoracic osteophytes from extruded disc material.
  • Adjacent disc volumes were not significantly different from the index disc (p=0.91).
  • Simulated calculations indicated that the calcific mass was unlikely to be extruded disc material (p=0.01).

Implications:

  • Giant thoracic osteophyte is a unique and rare pathological entity.
  • Surgical resection is the definitive treatment for spinal cord compression caused by these lesions.
  • Accurate differentiation from other spinal pathologies is essential for appropriate management.