Spinal Osteochondroma: Spectrum of a Rare Disease

Osteochondroma is a form of benign bone tumor. It is the most common form of benign bone tumor. Osteochondroma are composed of a bony component surrounded by a cartilaginous component. While most are found toward the ends of long bones, they have been found in the spine also. Most of the time in when found in the spine, they involve posterior elements such as the facet joints.

Some osteochondroma are hereditary, others are not. It is felt that some may occur as a result of trauma. They are also known to occur following radiation, particular in children who had radiation exposure when younger than age two. Spinal osteochondromas are discovered at an average age of 30 years. They occur more than twice as often in men than women.

These usually benign tumors can become malignant. Those that are herditary are most likely to be malignant. Those that are most often malignant have a cartilaginous cap that is greater than three centimeters thick.

The most common symptom that prompts work up is myelopathy. Myelopathy is weakness due to injury of the spinal cord. The authors discussed three case studies of subjects with spinal osteochrondromas. They ranged in age from 17 to 40 years. All of them had weakness of one or more extremities. One of the three subjects also experienced bladder dsyfunction. One half of the time, spinal osteochondromas involve the neck. The recommended treatment is removal of the tumor surgically. The cartilaginous cap should be completely removed for best results.

References: U. Srikantha et al. Spinal osteochondroma: spectrum of a rare disease. Journal of Neurosurgery:SpineJune 2008. Volume 8, Number 6. Pp. 561-566.

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