Xu Jun, Xu Chao-Rui, Wu Hong, Pan Hai-le, Tian Jun
Department of Orthopedics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
Orthopedics. 2009 Feb;32(2):133.
Osteochondromas, which are benign bone tumors that usually develop on long bones, tubular bones, are rarely found in the spine. If they are located in the spinal canal, they may cause nerve root or spinal cord compression, which is a rare but potentially catastrophic manifestation of osteochondromas. In this article, we report a case of a 38-year-old man who presented with low back pain, paresthesia, and weakness of the right lower extremity aggravating gradually for 5 months. No family history of this disease can be traced. The L4-L5 level computed tomography scan showed an abnormal bony protrusion arising from the right interior wall of L5 right lamina toward the intraspinal canal. The protrusion compressed the L5 nerve root severely. T2-weighted magnetic resonance imaging (MRI) of the same level revealed that the L5 nerve root and spinal dura mater were notably compressed by the intraspinal extradural exostosis attached to the right lamina of L5. Considering differential diagnosis, lumbar facet synovial cysts must be excluded as they can also cause myeloradiculopathy with the similar mechanism. The tumor, approximately 6x7x11 mm, was identified after laminectomy of the L5 laminae. Postoperative histopathologic examination confirmed our hypothesis of benign osteochondroma. Postoperatively, the patient recovered rapidly in neurological function and was free of symptoms. Surgery is essential to this rare case. Computed tomography and MRI are helpful for the preoperatively precise indication of tumor extent and its relationships with the adjacent.
骨软骨瘤是一种通常发生在长骨、管状骨上的良性骨肿瘤，很少见于脊柱。如果它们位于椎管内，可能会导致神经根或脊髓受压，这是骨软骨瘤一种罕见但可能具有灾难性的表现。在本文中，我们报告了一例38岁男性患者，他出现下腰痛、感觉异常和右下肢无力，症状逐渐加重达5个月。未发现该疾病的家族史。L4-L5水平的计算机断层扫描显示，一个异常的骨性突出物从L5右侧椎板的右内壁向椎管内突出。该突出物严重压迫L5神经根。同一水平的T2加权磁共振成像（MRI）显示，L5神经根和硬脊膜明显被附着在L5右侧椎板上的椎管内硬膜外骨疣压迫。考虑到鉴别诊断，必须排除腰椎小关节滑膜囊肿，因为它们也可通过类似机制导致脊髓神经根病。在L5椎板切除术后发现了这个大小约为6×7×11毫米的肿瘤。术后组织病理学检查证实了我们关于良性骨软骨瘤的推测。术后，患者神经功能迅速恢复且无症状。对于这个罕见病例，手术至关重要。计算机断层扫描和MRI有助于术前精确显示肿瘤范围及其与相邻结构的关系。
