Yudistira Andhika, Fujiwara Yasushi, Sukmajaya William Putera, Pandiangan Ray Asaf Hexa, Abduh Muhammad
Department of Orthopaedics and Traumatology, Saiful Anwar General Hospital-Universitas Brawijaya, Malang, Indonesia.
Department of Orthopaedic Surgery, Asa Citizens' Hospital, Hiroshima City, Japan.
Int J Surg Case Rep. 2020;69:13-19. doi: 10.1016/j.ijscr.2020.03.018. Epub 2020 Mar 28.
Osteochondroma is the most prevalent type of bone tumour, often arising in the long bones. Most are found in the third decade of life, and rarely in the axial skeleton of elderly patients. This case report aims to highlight the possibility of this differential diagnosis in an elderly patient with symptoms of radiculopathy, aside from degenerative cause.
A 76-years-old woman presented to the authors' hospital with complaints of pain and numbness of the left suboccipital and preauricular region. There was hypoesthesia of left C2 and C3 dermatome without any signs of myelopathy. CT-scan and MRI showed an expansile bone lesion from the posterior arch of C1 and lamina of C2. The patient underwent laminectomy of C1 and hemilaminectomy of C2. Postoperative histopathologic examination showed the features of osteochondroma. Radiologic follow-up after nine months showed no sign of recurrence. After eighteen months, the patient was ambulatory with complaints of fingers numbness and moderate neck pain.
Osteochondroma usually arises in long bone metaphysis. This lesion normally ceases to grow with growth plate closure, but other findings suggest it may continue to grow beyond skeletal maturity. About 29.5% of all osteochondroma of the spine would cause radiculopathy, and 27% would cause myelopathy. The cervical spine osteochondroma is usually treated by en bloc resection through posterior approach.
Osteochondroma of the cervical spine in the elderly is rare. However, this diagnosis could be considered as a possible cause of radiculopathy in this age group aside from other degenerative causes.
骨软骨瘤是最常见的骨肿瘤类型，常发生于长骨。大多数在生命的第三个十年被发现，很少见于老年患者的中轴骨骼。本病例报告旨在强调除退行性病因外，老年神经根病患者存在这种鉴别诊断的可能性。
一名76岁女性因左枕下和耳前区域疼痛及麻木就诊于作者所在医院。左侧C2和C3皮节感觉减退，无任何脊髓病体征。CT扫描和MRI显示C1后弓和C2椎板有一膨胀性骨病变。患者接受了C1椎板切除术和C2半椎板切除术。术后组织病理学检查显示为骨软骨瘤特征。九个月后的影像学随访未显示复发迹象。十八个月后，患者可行走，但仍有手指麻木和中度颈部疼痛的主诉。
骨软骨瘤通常发生于长骨的干骺端。这种病变通常在生长板闭合后停止生长，但其他研究结果表明它可能在骨骼成熟后继续生长。所有脊柱骨软骨瘤中约29.5%会导致神经根病，27%会导致脊髓病。颈椎骨软骨瘤通常通过后路整块切除进行治疗。
老年颈椎骨软骨瘤罕见。然而，除其他退行性病因外，该诊断可被视为该年龄组神经根病的一种可能病因。
