Langerhans' cell histiocytosis of the spine in children

Between May 1972 and December 1991, 58 children were seen in the authors' institution for treatment of Langerhans' cell histiocytosis. Of these, 15 children (7 males, 8 females) had biopsy-proven Langerhans' cell histiocytosis with vertebral involvement. The average age at presentation was 6.4 years (range, 0.2-13.3 years). At presentation, 8 patients had involvement of a single vertebra and 4 had involvement of multiple vertebrae. Nine patients had extraspinal skeletal involvement. Two patients had visceral involvement. Currently, 13 patients have had >2 years followup (average, 8.9 years; range, 2-21 years). None of these patients had clinical evidence of disease at the latest encounter. This group of patients with Langerhans' cell histiocytosis with vertebral involvement has fared well. Most patients have had involvement of multiple vertebrae and many have had extraspinal bony involvement as well. There was a great deal of variability in the extent of collapse and reconstitution of vertebral height, and the amount of reconstitution did not correlate with patient age.