Cervical spinal myelopathy secondary to cervical exostoses: A rare cause of cord compression - A case report

Multiple hereditary exostoses (MHE) is a rare autosomal dominant disorder. It is characterized by the development of cartilage-capped bony outgrowths arising from the epiphyseal or diaphyseal regions of long bones, leading to reduced joint motion and pain secondary to compression. MHE is attributed to the predominant exostin-1 and exostin-2 mutations that cause multiple osteochondromas. The most common locations of these lesions are on the knee joint, humerus, pelvis, scapula, and also the spine.

A 26-year-old Caucasian male with a diagnosis of MHE, presenting with progressive spastic tetraparesis. The cervical magnetic resonance (MR) revealed an osteochondroma arising from the C2 lamina dorsolaterally compressing the spinal cord at the C1-C2 level. Following a C2 laminectomy, the postoperative MR imaging confirmed gross total lesion excision. Postoperatively, the patient's myelopathy gradually improved and was discharged to a rehabilitation facility.

Rarely, MHE spinal osteochondromas cause spinal cord compression that is readily relieved with typical decompressive procedures.