Montgomery Canada T, Miranda Stephen P, Nelson Ernest, Louka Katie, Nasrallah MacLean, Zhang Paul J, Stein Joel, Petrov Dmitriy
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States.
Front Surg. 2022 Jun 29;9:890965. doi: 10.3389/fsurg.2022.890965. eCollection 2022.
Spinal osteoblastomas are primary benign bone tumors most commonly presenting as diffuse back pain in young adults. Rarely, spinal osteoblastoma is associated with ossification of the ligamentum flavum (OLF), a form of ectopic bone formation, which can present with myelopathy. This report highlights a unique case of a patient with spinal osteoblastoma, associated OLF, and thoracic myelopathy.
The patient presented with subtle myelopathy consisting of mid-thoracic back pain, paresthesias, and gait instability. Imaging findings were suggestive of spinal osteoblastoma with multifocal OLF. The patient was consented for thoracic decompression and stabilization at the T6-10 levels. Histopathology confirmed osteoblastoma with associated OLF. At follow up, the patient's neurological symptoms had completely resolved.
This case describes management for a rare presentation of osteoblastoma with associated OLF and myelopathy. Surgeons should be wary of disproportionate neurological compromise when spinal osteoblastoma is associated with OLF. Further study is required to elucidate the pathogenesis of this condition.
脊柱骨母细胞瘤是原发性良性骨肿瘤，在年轻成年人中最常表现为弥漫性背痛。脊柱骨母细胞瘤很少与黄韧带骨化（OLF）相关，OLF是一种异位骨形成形式，可表现为脊髓病。本报告重点介绍了一例患有脊柱骨母细胞瘤、合并OLF和胸段脊髓病的独特病例。
该患者表现为轻微脊髓病，包括胸中部背痛、感觉异常和步态不稳。影像学检查结果提示脊柱骨母细胞瘤合并多灶性OLF。患者同意在T6 - 10水平进行胸椎减压和固定术。组织病理学证实为骨母细胞瘤合并OLF。随访时，患者的神经症状已完全缓解。
本病例描述了骨母细胞瘤合并OLF和脊髓病这一罕见表现的治疗方法。当脊柱骨母细胞瘤与OLF相关时，外科医生应警惕不成比例的神经功能损害。需要进一步研究以阐明这种情况的发病机制。
