Lumbar Solitary Osteochondroma with Lower Extremity Weakness: A Case Report

Takahiro Sato, H. Kinoshita, Takashi Kobayashi, N. Miyakoshi
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Abstract

Osteochondroma is the most common benign bone tumor. However, osteochondroma of the spine is relatively rare, accounting for only 4% to 7% of primary benign spinal tumors and less than 3% of all osteochondromas. Furthermore, symptomatic osteochondroma in the lumbar spine is much rarer. We herein describe a patient who was diagnosed with a lumbar solitary osteochondroma causing neurological symptoms of the lower extremities. The patient successfully underwent surgical removal of the lesion. A 79-year-old man presented with a 3-year history of difficulty walking and gradual development of numbness in his left upper extremity, which further exacerbated his difficulty walking. Magnetic resonance imaging and computed tomography revealed spinal stenosis at C3/4, L4/5, and L5/S1 and an osseous solitary lesion. We performed a single-stage operation of both the cervical and lumbar spine. The osseous solitary lesion at L5/S1 was removed, and the pathological diagnosis was osteochondroma. After the operation, the patient’s upper extremity numbness and walking ability were improved. We experienced a rare case of a neurologically symptomatic solitary osteochondroma in the lumbar spinal canal. Moreover, this lesion was found at the same time as cervical spondylosis causing numbness. Therefore, we must perform careful examinations and thoroughly evaluate imaging and postoperative pathological findings.
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腰椎孤立性骨软骨瘤伴下肢无力1例报告
骨软骨瘤是最常见的骨良性肿瘤。然而脊柱骨软骨瘤相对少见,仅占脊柱原发性良性肿瘤的4% ~ 7%,不到所有骨软骨瘤的3%。此外,腰椎的症状性骨软骨瘤非常罕见。我们在此描述一个被诊断为腰椎孤立性骨软骨瘤引起下肢神经系统症状的患者。病人成功地接受了手术切除病变。79岁男性,有3年行走困难病史,左上肢逐渐麻木,进一步加重了行走困难。磁共振成像和计算机断层扫描显示C3/4、L4/5和L5/S1椎管狭窄和骨性孤立病变。我们对颈椎和腰椎进行了一次手术。切除L5/S1骨孤立病变,病理诊断为骨软骨瘤。术后患者上肢麻木及行走能力均有改善。我们经历了一个罕见的病例神经症状孤立性骨软骨瘤在腰椎管。此外,这种病变与颈椎病同时发现,引起麻木。因此,我们必须进行仔细的检查,彻底评估影像学和术后病理结果。
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