The solitary intraspinal vertebral osteochondroma - An unusual cause of compressive myelopathy: Features and literature review

Study Design. Reports of four patients with compressive myelopathy from sol itary intraspinal vertebral osteochondromas. Objectives. To evaluate the clinical presentation and radiographic findings of patients with intraspinal osteochondroma with compressive myelopathy an d to review the relevant English-language medical literature. Summary of Background Data. Involvement of the spine by solitary osteochond romas is rare. The addition of the current four cases to those already repo rted makes a total of 41 published cases of solitary vertebral osteochondro mas with spinal cord compression. Methods. Clinical histories, computed tomographic studies, magnetic resonan ce imaging studies, routine radiographs, and/or myelographic studies of the lesions were reviewed. A review of the English-language medical literature also was done. Results. Patients gradually improved or symptoms stopped progressing after surgical removal of the lesions. Although magnetic resonance imaging is the preferred method for localizing the,lesion, computed tomography can be mor e specific, because of its sensitivity, when the diagnosis is in doubt. Conclusions. Osteochondromas represent a hyper plastic-dysplastic disturban ce of bone from progressive endochondral ossification. The tumors slowly en large, creating insidious but progressive symptoms. Magnetic resonance imag ing, computed tomography, and postmyelogram computed tomography are useful in evaluating the size and extent of spinal osteochondromas as a cause of s pinal cord compression.