PIGMENTED VILLONODULAR SYNOVITIS OF THE SPINE - A CLINICAL, RADIOLOGICAL, AND MORPHOLOGICAL-STUDY OF 12 CASES

Cases of pigmented villonodular synovitis (PVNS) that affect the axial skeleton are rare and thus information regarding its natural history, treatment, and prognosis remains limited. To characterize this lesion more fully, the authors reviewed their experience with 12 cases of PV NS of the spine (one of which had been previously reported), then revi ewed the 11 cases that previously had been reported, and obtained addi tional follow-up data in six of them. On the basis of the cumulative d ata provided by these 22 cases, PVNS of the spine appears to occur ove r a wide range of ages (21-81 years) and, contrary to what was previou sly suggested, does not show definite gender predilection (12 women an d 10 men). The lesion affects the posterior elements of the vertebrae at all levels and involves the facet joints in 89% of cases. Extension into the epidural spine is frequent (70%). Surgical resection appears to be the treatment of choice. Although PVNS of the spine tends to re cur locally (18%), repeat surgical excision appears to be curative.