Course of spinal solitary osteochondromas.
METHODS
Six spinal solitary osteochondromas.


OBJECTIVE
To evaluate the course of spinal cord compression after surgery, and the risk of local recurrence and malignant transformation, based on the present series and cases reported in the literature.


BACKGROUND
Spinal cord compression by a solitary osteochondroma is rare. Little is known concerning neurologic improvement after decompression of the spinal cord or the risk of recurrence or malignant transformation of spinal solitary osteochondroma, because most of the cases reported are isolated.


METHODS
Clinical history, plain radiographs, pathologic features, computed tomographic studies, and magnetic resonance imaging were reviewed. Five patients underwent long-term follow-up physical examination and computed tomography for an average of 6 years (range, 2-12 years) after surgical treatment. The literature was reviewed for solitary osteochondroma with spinal cord compromise, recurrent solitary osteochondroma, or solitary osteochondroma in the process of sarcomatous transformation.


RESULTS
In the present study, two of the six patients experienced spinal cord compromise. Neurologic deficits improved after surgery. None of the patients had local recurrence or malignant transformation at follow-up observation. Including these two patients, the authors found 62 cases of solitary osteochondroma with spinal cord compromise in the literature. Overall, three patients died, eight did not improve, and 48 (81%) experienced regression of the neurologic deficit after surgical decompression. Among the 150 cases of solitary osteochondroma the authors found in the literature, there were six cases (4%) of local recurrence and four cases (2.7%) of malignant transformation.


CONCLUSIONS
Surgical treatment improves neurologic deficit in more than 80% of cases of spinal cord compromise caused by solitary osteochondroma. The risk of recurrence or sarcomatous transformation justifies clinical and radiologic follow-up review.
Gille
Olivier
O
University Hospital of Bordeaux, Spinal Unit, Department of Orthopaedic Surgery, Bordeaux, France. olivier.gille@chu-bordeaux.fr
Pointillart
Vincent
V
Vital
Jean-Marc
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D015831:Osteochondroma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D012307:Risk Factors; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome