Solitary Thoracic Spine Osteochondroma: An Unusual Cause of Spinal Cord Compression

Abstract

Osteochondromas are common benign bone tumors that rarely arise in spine and can originate as solitary lesions or in the context of hereditary multiple exostoses. Intraspinal presentation of these tumors is usually circumscribed to the cervical regions with few tumors presenting in the thoracic vertebrae, where they can cause a variety of signs and symptoms, including those of spinal cord or spinal root compression. The authors present a 37-year-old man with paraplegia, sensory level, and both sphincter incontinence with a thoracic solitary osteochondroma and review the cases reported in the literature. The symptoms disappeared after surgical removal of the lesions. Histopathologic examination confirmed the diagnosis of benign osteochondroma. In the authors' experience, early detection and surgical removal in cases of symptomatic spinal osteochondroma is a key element for the best outcome. Posterior approaches are generally sufficient. The chronicity of symptoms may limit functional recovery postoperatively, especially with cervical and thoracic lesions. The majority of surgically treated patients improve, with about three-quarters of the improved patients having no residual disease or only minor deficits.