EOSINOPHILIC GRANULOMA OF THE SPINE

Twenty patients treated for eosinophilic granuloma of the spine were s tudied. Only 40% demonstrated the classical radiographic picture of ve rtebra plana. In 60% a lyric lesion of the vertebral body ol the poste rior elements was found. Seven patients underwent surgery; the indicat ions were neurological involvement or failure of this biopsy to disclo se the diagnosis. At an average follow-up period of 7 years, 17 patien ts are well and alive with nw residual spinal pain, neurological compr omise, recurrent disease, or extraskeletal involvement. Vertebral body collapse underwent some regeneration but did not regain full body hei ght. In several patients this resulted in a local deformity. In patien ts with unifocal spinal eosinophilic granuloma, watchful observation w ith Ilo treatment other than spinal support is warranted. In patients with neural involvement or multifocal lesions, a more active treatment , including surgery, may be indicated.