title: Symptomatic lumbar osteochondroma treated via a multidisciplinary military surgical team: case report and review of the literature.
abstract: The authors describe the case of a giant osteochondroma emanating from the L5 vertebral body and extending into the retroperitoneum of a 40-year-old man, causing low back pain. Osteochondromas are benign bony tumors that typically occur within the appendicular skeleton, although in the sporadic form, up to 4% occur in the spine. A review of the English language literature has returned 44 cases of lumbar osteochondroma, including the present example. The lesions were sporadic in 81% of cases. Mean age of presentation overall is 39.5 years, with a mean age of 18.4 years (range 8-34 years) for hereditary cases and 45.7 years (range 11-81 years) for solitary lesions. Of the instances where gender was reported, 64% were male. The most common level of origin was L4 (38%). The most common anatomic site of origin was the inferior articular process (one-third). Of those lesions treated operatively, 46% underwent simple decompression, with 22% requiring decompression and fusion. This particular lesion was resected via a transperitoneal approach performed by a multidisciplinary team of neurosurgeons, vascular surgeons, and urologists. The bony tumor measured 6.1 × 7.8 × 7.7 cm. Removal of the lesion resulted in a significant improvement of the patient's symptoms.
authors.affiliation: Department of Neurosurgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20814.
authors.forename: George N
authors.initials: GN
authors.lastname: Rymarczuk
authors.affiliation: Department of Neurosurgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20814.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Dirks
authors.affiliation: Department of Vascular Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20814.
authors.forename: David R
authors.initials: DR
authors.lastname: Whittaker
authors.affiliation: Department of Neurosurgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20814.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Neal
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D017116:Low Back Pain; D008159:Lumbar Vertebrae; D008297:Male; D008887:Military Medicine; D015831:Osteochondroma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010348:Patient Care Team; D012187:Retroperitoneal Space