Osteocondromas da coluna vertebral: um diagnóstico a considerar nas síndromes de compressão medular

Botelho, Carlos H. A.; Kalil, Ricardo K.

doi:10.1590/S0004-282X1996000400010

Resumos

Os autores realizaram revisão dos 312 casos de osteocondroma solitário e osteocondromatose múltipla, atendidos no Hospital SARAH do Aparelho Locomotor durante período de 13 anos - compreendido entre 1982 e 1994. Destes, foram selecionados seis casos de pacientes com lesão da coluna vertebral, correspondendo a 1,92% do total de casos diagnosticados desta entidade. Os casos selecionados foram submetidos a propedêutica radiológica que envolveu radiografias simples, mielografia, tomografia computadorizada e, em um dos casos, ressonância magnética. Todos foram submetidos a procedimento cirúrgico descompressivo, com retirada das lesões, as quais foram encaminhadas a análise histopatológica que confirmou a impressão diagnóstica inicial. Este estudo abrange ainda revisão dos possíveis mecanismos implicados na patogênese do processo.

osteocondromas; coluna vertebral; compressão medular

The authors reviewed 312 cases of solitary and multiple osteochondromas seen in SARAH Hospital for the Locomotor System during a period of 13 years - from 1982 to 1994. They selected six cases of patients with osteochondromas of the spine, corresponding to 1.92% of the total number of diagnosed cases of this entity. The selected cases were submitted to roentgenographic examination that comprised plain roentgenograms, myelography, computerized tomography and, in one of them, magnetic resonance imaging. They were submitted to decompressive surgical procedures (including laminectomy) with exeresis of the lesions and posterior histopathological examination which confirmed the initial diagnostic hypothesis. This study also includes a review of the possible mechanisms implicated in the pathogenesis of the disease.

osteochondromas; spine; spinal cord compression

Osteocondromas da coluna vertebral: um diagnóstico a considerar nas síndromes de compressão medular

Osteochondromas of the spine: a diagnosis to consider in spinal cord compression syndromes

Carlos H. A. Botelho; Ricardo K. Kalil

Serviço de Patologia, Rede SARAH de Hospitais do Aparelho Locomotor - Hospital SARAH, Brasília

RESUMO

Os autores realizaram revisão dos 312 casos de osteocondroma solitário e osteocondromatose múltipla, atendidos no Hospital SARAH do Aparelho Locomotor durante período de 13 anos - compreendido entre 1982 e 1994. Destes, foram selecionados seis casos de pacientes com lesão da coluna vertebral, correspondendo a 1,92% do total de casos diagnosticados desta entidade. Os casos selecionados foram submetidos a propedêutica radiológica que envolveu radiografias simples, mielografia, tomografia computadorizada e, em um dos casos, ressonância magnética. Todos foram submetidos a procedimento cirúrgico descompressivo, com retirada das lesões, as quais foram encaminhadas a análise histopatológica que confirmou a impressão diagnóstica inicial. Este estudo abrange ainda revisão dos possíveis mecanismos implicados na patogênese do processo.

Palavras-chave: osteocondromas, coluna vertebral, compressão medular.

ABSTRACT

The authors reviewed 312 cases of solitary and multiple osteochondromas seen in SARAH Hospital for the Locomotor System during a period of 13 years - from 1982 to 1994. They selected six cases of patients with osteochondromas of the spine, corresponding to 1.92% of the total number of diagnosed cases of this entity. The selected cases were submitted to roentgenographic examination that comprised plain roentgenograms, myelography, computerized tomography and, in one of them, magnetic resonance imaging. They were submitted to decompressive surgical procedures (including laminectomy) with exeresis of the lesions and posterior histopathological examination which confirmed the initial diagnostic hypothesis. This study also includes a review of the possible mechanisms implicated in the pathogenesis of the disease.

Key words: osteochondromas, spine, spinal cord compression.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 26-julho-1996.

Dr. Carlos Henrique de Aguiar Botelho - Serviço de Patologia, Hospital SARAH - W3 Sul, Q 501, SMHS -70330-150 Brasília DF - Brasil. FAX 061 319 1564.

1. Albrecht S, Crutchfield S, Segall GK. On spinal osteochondromas. J Neurosurg 1992;77:247-252.
2. Bridge J. Cytogenetic and molecular cytogenetic techniques in orthopaedic surgery. J Bone Joint Surg 1993;75:606-614.
3. Calhoun J, Chadduck WM, Smith JL. Single cervical exostosis: report of a case and review of the literature. Surg Neurol 1992;37:26-29.
4. Cohn RS, Fielding JW. Osteochondroma of the cervical spine. J Pediat Surg 1986;21:997-999.
5. Cree AK, Hadlow AT, Taylor TKF, Chapman GK. Radiation-induced osteochondroma in the lumbar spine. Spine 1994;19:376-379.
6. Esposito PW, Crawford AH, Vogler C. Solitary osteochondroma occurring on the transverse process of the lumbar spine. Spine 1985;10:398-400.
7. Fielding W, Ratzan S. Osteochondroma of the cervical spine. J Bone Joint.Surg 1973;55:640-641.
8. George B, Atallah A, Laurian C, Tayon B, Mikol J. Cervical osteochondroma (C2 level) with vertebral artery occlusion and second cervical nerve root irritation. Surg Neurol 1989;31:459-464.
9. Gottlieb A, Seven P, Ruelle A, Lasio G. Exostosis as a cause of spinal cord compression. Surg Neurol 1986;26:581-584.
10. Jaffe HL. Tumors and tumorous conditions of the bones and joints. Philadelphia: Lea & Febiger, 1968.
11. Karian JM, DeFilipp G, Buchheit WA, Bonakdarpour A, Eckhardt W. Vertebral osteochondroma causing spinal cord compression: case report. Neurosurgery 1984;14:483-484.
12. Loftus CM, Rozario RA, Prager R, Scott RM. Solitary osteochondroma of T4 with cord compression. Surg Neurol 1980;13:355-357.
13. Madigan R. Cervical cord compression in hereditary multiple exostosis. J Bone Joint Surg 1974;56:401 -404.
14. Malat J, Virapongse C, Levine A. Solitary osteochondroma of the spine. Spine 1986; 11:625-628.
15. Marchand EP. Solitary osteochondroma of the thoracic spine presenting as spinal cord compression: a case report. Spine 1986;11;1033-1035.
16. Mirra JM. Bone tumors: clinical, radiologic and pathologic correlations. Philadelphia: Lea & Febiger, 1989.
17. Montgomery PQ. Solitary osteochondroma causing sural nerve entrapment neuropathy. J R Soc Med 1988;82:761.
18. Morard M, De Preux J. Solitary osteochondroma presenting as a neck mass with spinal cord compression syndrome. Surg Neurol 1992;37:402-405.
19. Novick GS, Pavlov H, Bullough PG. Osteochondroma of the cervical spine: report of two cases in preadolescent males. Skel Radiol 1982;8:13-15.
20. Palmer FJ, Blum PW. Osteochondroma with spinal cord compression: report of three cases. J Neurosurg 1980;52:842-845.
21. Prasad A, Renjen PN, Prasad ML, Bhatty GB, Madan VS. Buxi TB, Agarwal SP. Solitary spinal osteochondroma causing neural syndromes. Paraplegia 1992;30:678-680.
22. Royster RM, Kujawa P, Dryer RF. Multilevel osteochondroma of the lumbar spine presenting as spinal stenosis. Spine 1991;16:992-993.
23. Spaziante R. Osteochondroma of the spine (Letter). Neurosurgery 1991;28:931-932.
24. Spaziante R, Irace C, Gambardella A, Cappabianca P, De Divitiis E. Solitary osteochondroma of the pedicle of L4 causing root compression. J Neurosurg Sci 1988;32:141-145.
25. Tajima K, Nishida J, Yamazaki K, Shimamura T, Abe M. Case report 545. Skel Radiol 1989;18:306-309.
26. Van Der Sluis R, Gurr K, Joseph MG. Osteochondroma of the lumbar spine: an unusual case of sciatica. Spine 1992;17:1519-1521.
27. Yablon JS. Letter. Neurosurgery 1990;27:659-660.

Datas de Publicação

Publicação nesta coleção
12 Nov 2010
Data do Fascículo
Dez 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Albrecht S, Crutchfield S, Segall GK. On spinal osteochondromas. J Neurosurg 1992;77:247-252.

[2] 2. Bridge J. Cytogenetic and molecular cytogenetic techniques in orthopaedic surgery. J Bone Joint Surg 1993;75:606-614.

[3] 3. Calhoun J, Chadduck WM, Smith JL. Single cervical exostosis: report of a case and review of the literature. Surg Neurol 1992;37:26-29.

[4] 4. Cohn RS, Fielding JW. Osteochondroma of the cervical spine. J Pediat Surg 1986;21:997-999.

[5] 5. Cree AK, Hadlow AT, Taylor TKF, Chapman GK. Radiation-induced osteochondroma in the lumbar spine. Spine 1994;19:376-379.

[6] 6. Esposito PW, Crawford AH, Vogler C. Solitary osteochondroma occurring on the transverse process of the lumbar spine. Spine 1985;10:398-400.

[7] 7. Fielding W, Ratzan S. Osteochondroma of the cervical spine. J Bone Joint.Surg 1973;55:640-641.

[8] 8. George B, Atallah A, Laurian C, Tayon B, Mikol J. Cervical osteochondroma (C2 level) with vertebral artery occlusion and second cervical nerve root irritation. Surg Neurol 1989;31:459-464.

[9] 9. Gottlieb A, Seven P, Ruelle A, Lasio G. Exostosis as a cause of spinal cord compression. Surg Neurol 1986;26:581-584.

[10] 10. Jaffe HL. Tumors and tumorous conditions of the bones and joints. Philadelphia: Lea & Febiger, 1968.

[11] 11. Karian JM, DeFilipp G, Buchheit WA, Bonakdarpour A, Eckhardt W. Vertebral osteochondroma causing spinal cord compression: case report. Neurosurgery 1984;14:483-484.

[12] 12. Loftus CM, Rozario RA, Prager R, Scott RM. Solitary osteochondroma of T4 with cord compression. Surg Neurol 1980;13:355-357.

[13] 13. Madigan R. Cervical cord compression in hereditary multiple exostosis. J Bone Joint Surg 1974;56:401 -404.

[14] 14. Malat J, Virapongse C, Levine A. Solitary osteochondroma of the spine. Spine 1986; 11:625-628.

[15] 15. Marchand EP. Solitary osteochondroma of the thoracic spine presenting as spinal cord compression: a case report. Spine 1986;11;1033-1035.

[16] 16. Mirra JM. Bone tumors: clinical, radiologic and pathologic correlations. Philadelphia: Lea & Febiger, 1989.

[17] 17. Montgomery PQ. Solitary osteochondroma causing sural nerve entrapment neuropathy. J R Soc Med 1988;82:761.

[18] 18. Morard M, De Preux J. Solitary osteochondroma presenting as a neck mass with spinal cord compression syndrome. Surg Neurol 1992;37:402-405.

[19] 19. Novick GS, Pavlov H, Bullough PG. Osteochondroma of the cervical spine: report of two cases in preadolescent males. Skel Radiol 1982;8:13-15.

[20] 20. Palmer FJ, Blum PW. Osteochondroma with spinal cord compression: report of three cases. J Neurosurg 1980;52:842-845.

[21] 21. Prasad A, Renjen PN, Prasad ML, Bhatty GB, Madan VS. Buxi TB, Agarwal SP. Solitary spinal osteochondroma causing neural syndromes. Paraplegia 1992;30:678-680.

[22] 22. Royster RM, Kujawa P, Dryer RF. Multilevel osteochondroma of the lumbar spine presenting as spinal stenosis. Spine 1991;16:992-993.

[23] 23. Spaziante R. Osteochondroma of the spine (Letter). Neurosurgery 1991;28:931-932.

[24] 24. Spaziante R, Irace C, Gambardella A, Cappabianca P, De Divitiis E. Solitary osteochondroma of the pedicle of L4 causing root compression. J Neurosurg Sci 1988;32:141-145.

[25] 25. Tajima K, Nishida J, Yamazaki K, Shimamura T, Abe M. Case report 545. Skel Radiol 1989;18:306-309.

[26] 26. Van Der Sluis R, Gurr K, Joseph MG. Osteochondroma of the lumbar spine: an unusual case of sciatica. Spine 1992;17:1519-1521.

[27] 27. Yablon JS. Letter. Neurosurgery 1990;27:659-660.