Departments of Neurosurgery and.
J Neurosurg. 2014 May;120(5):1105-12. doi: 10.3171/2013.11.JNS13310. Epub 2014 Jan 3.
Nerve compressions due to osteochondromas are extremely rare. The aim of this retrospective study was to investigate the mechanisms, diagnostic evaluations, and treatment of nerve lesions due to osteochondromas, and to review the literature.
The authors retrospectively reviewed their clinic data archive from 1998 through 2008, and 20 patients who were operated on due to peripheral nerve injuries caused by osseous growth were enrolled in the study. Patients' age, duration of symptoms, localizations, intraoperative findings, and modified British Medical Research Council (MRC) and electromyography data obtained from hospital records were evaluated. The literature on this topic available in PubMed was also reviewed. All 20 patients underwent surgery, which consisted of tumor excision performed by orthopedic surgeons and nerve decompression performed by neurosurgeons.
There were 17 men and 3 women included in the study, with a mean age of 21 years (range 18-25 years). Three patients had multiple hereditary exostoses, and 17 had a solitary exostosis. All of the patients underwent en bloc resection. The most common lesion site was the distal femur (45%). The peroneal and posterior tibial nerves were the structures that were affected the most frequently. The mean follow-up was 3.9 years (range 2-7 years). After the surgery, all patients (100%) experienced good sensory recovery (modified MRC Grade S4 or S5).
To the authors' knowledge, no large series have reported peripheral nerve compression due to exostoses. The authors have several recommendations as a result of their findings. First, all patients with peripheral nerve compression due to an osteochondroma should undergo surgery. Second, preoperative electromyographic examinations and radiographic evaluation, consisting of MRI and CT to provide optimal information about the lesion, are crucially important. Third, immediate treatment is mandatory to regain the best possible recovery. And fourth, performing nerve decompression first and en bloc resection of osteochondroma consecutively in a multidisciplinary fashion is strongly recommended to avoid peripheral nerve injury.
神经受压是由于软骨瘤极其罕见。本回顾性研究的目的是探讨神经病变的机制、诊断评估和治疗软骨瘤，并复习文献。
作者回顾性地分析了他们 1998 年至 2008 年的临床资料档案，并对 20 例因骨生长引起周围神经损伤而接受手术的患者进行了研究。评估了患者的年龄、症状持续时间、局部定位、术中发现以及从医院记录中获得的改良英国医学研究理事会（MRC）和肌电图数据。还在 PubMed 上查阅了关于这个主题的文献。所有 20 例患者均接受手术治疗，包括骨科医生进行的肿瘤切除术和神经外科医生进行的神经减压术。
研究包括 17 名男性和 3 名女性，平均年龄 21 岁（18-25 岁）。3 例患者患有多发性遗传性外生骨疣，17 例患者患有孤立性外生骨疣。所有患者均行整块切除术。最常见的病变部位是股骨远端（45%）。最常受影响的结构是腓总神经和胫后神经。平均随访 3.9 年（2-7 年）。手术后，所有患者（100%）均有良好的感觉恢复（改良 MRC 分级 S4 或 S5）。
据作者所知，没有大系列报道过外生骨疣引起的周围神经压迫。作者根据他们的发现提出了一些建议。首先，所有因软骨瘤引起的周围神经受压的患者都应接受手术治疗。其次，术前肌电图检查和影像学评估（包括 MRI 和 CT）对于提供关于病变的最佳信息至关重要。第三，必须立即进行治疗以获得最佳的恢复。第四，强烈建议采用多学科方式先进行神经减压，然后连续整块切除软骨瘤，以避免周围神经损伤。
