Eosinophilic granuloma of the cervical spine.
METHODS
A meta-analysis was performed based on 53 cases of cervical eosinophilic granuloma reported in the literature and 1 in an adult treated by the authors.


OBJECTIVE
To stress the clinical and radiologic differences between cervical and thoracolumbar spinal eosinophilic granuloma and to point out differences between adults and children with cervical eosinophilic granuloma to avoid false diagnosis.


BACKGROUND
Until now, cervical eosinophilic granuloma has been reported in 43 children and 9 adults. In 1 case the age is unknown. In previous studies, differences between adults and children with cervical eosinophilic granuloma have not been analyzed, nor has cervical eosinophilic granuloma been compared with thoracolumbar eosinophilic granuloma.


METHODS
All reported cases of cervical eosinophilic granuloma were analyzed concerning age and sex distribution, clinical and radiologic presentation, therapy, and outcome. The authors' case in a 46-year-old patient is discussed.


RESULTS
The presenting symptoms of cervical eosinophilic granuloma are usually pain and restricted range of motion. In contrast to eosinophilic granuloma of the thoracic spine and lumbar spine, the neurologic symptoms are less frequent, and the first radiographic sign is an osteolytic lesion. Vertebra plana is a rare sign in cervical eosinophilic granuloma. In children, the middle cervical spine is most often affected, whereas in adults it is the second vertebra. The outcome of the patients has been good in most cases, independently of treatment.


CONCLUSIONS
In most cases of cervical eosinophilic granuloma, immobilization is an adequate therapy. If the process continuous to progress, radiotherapy is recommended. Surgical treatment should be reserved for cases with instability or neurologic defects.
Department of Traumatology, Allgemeines Krankenhaus St. Georg, Hamburg, Germany. christoph.bertram@medizin.uni-koeln.de
Christoph
C
Bertram
Jürgen
J
Madert
Christoph
C
Eggers
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001915:Braces; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004803:Eosinophilic Granuloma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D011859:Radiography; D011877:Radionuclide Imaging; D017678:Sex Distribution; D013122:Spinal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D013667:Technetium; D016896:Treatment Outcome
D013667:Technetium