Ali Ashraf1, A Noelle Larson2, Gabriela Ferski3, Cary H Mielke3, Nicholas M Wetjen4, Kenneth J Guidera3. 1. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905 USA. 2. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905 USA ; Shriners Hospitals for Children-Twin Cities, Minneapolis, MN USA. 3. Shriners Hospitals for Children-Twin Cities, Minneapolis, MN USA. 4. Department of Neurosurgery, Mayo Clinic, Rochester, MN USA.
Abstract
PURPOSE: Children with multiple hereditary exostoses (MHE) have numerous osteochondromas, with the most prominent lesions typically over the appendicular skeleton. A recent report noted a high rate of intracanal lesions in this patient population and recommended preventative spinal screening with magnetic resonance imaging (MRI) or computed tomography (CT). We sought to evaluate the prevalence of spinal stenosis from intracanal osteochondromas at our pediatric orthopedic center in order to evaluate if routine screening is warranted. METHODS: All pediatric patients treated for MHE were retrospectively identified. Records were reviewed to determine demographics, previous orthopedic surgery, and indication and results of axial spine imaging (CT or MRI). Imaging studies were reviewed to evaluate the presence of intracanal and compressive spinal lesions. RESULTS: Between 1990 and 2011, axial imaging was performed in nine patients with MHE due to concerns of pain, weakness, and/or dizziness. These patients had moderate disease involvement, with a mean of 4.9 previous orthopedic surgeries to address skeletal osteochondromas. Two patients with MHE had cervical spinal stenosis secondary to intracanal osteochondromas. Both children successfully underwent spinal decompression. Thus, of our MHE population undergoing axial imaging, 22 % were noted to have intracanal lesions. CONCLUSIONS: Our experience reveals a >20 % rate of compressive intracanal osteochondromas in MHE patients undergoing spinal imaging. These two patients represent 5 % of the MHE patients treated at our center. These lesions may be slow growing, and significant consequences can occur if not identified promptly. Thus, we confer that routine axial screening of the spinal canal may be warranted in these children.
PURPOSE:Children with multiple hereditary exostoses (MHE) have numerous osteochondromas, with the most prominent lesions typically over the appendicular skeleton. A recent report noted a high rate of intracanal lesions in this patient population and recommended preventative spinal screening with magnetic resonance imaging (MRI) or computed tomography (CT). We sought to evaluate the prevalence of spinal stenosis from intracanal osteochondromas at our pediatric orthopedic center in order to evaluate if routine screening is warranted. METHODS: All pediatric patients treated for MHE were retrospectively identified. Records were reviewed to determine demographics, previous orthopedic surgery, and indication and results of axial spine imaging (CT or MRI). Imaging studies were reviewed to evaluate the presence of intracanal and compressive spinal lesions. RESULTS: Between 1990 and 2011, axial imaging was performed in nine patients with MHE due to concerns of pain, weakness, and/or dizziness. These patients had moderate disease involvement, with a mean of 4.9 previous orthopedic surgeries to address skeletal osteochondromas. Two patients with MHE had cervical spinal stenosis secondary to intracanal osteochondromas. Both children successfully underwent spinal decompression. Thus, of our MHE population undergoing axial imaging, 22 % were noted to have intracanal lesions. CONCLUSIONS: Our experience reveals a >20 % rate of compressive intracanal osteochondromas in MHE patients undergoing spinal imaging. These two patients represent 5 % of the MHE patients treated at our center. These lesions may be slow growing, and significant consequences can occur if not identified promptly. Thus, we confer that routine axial screening of the spinal canal may be warranted in these children.
Authors: Charles A Sansur; Nader Pouratian; Aaron S Dumont; David Schiff; Christopher I Shaffrey; Mark E Shaffrey Journal: Lancet Oncol Date: 2007-02 Impact factor: 41.316
Authors: Sayantani Sinha; Christina Mundy; Till Bechtold; Federica Sgariglia; Mazen M Ibrahim; Paul C Billings; Kristen Carroll; Eiki Koyama; Kevin B Jones; Maurizio Pacifici Journal: PLoS Genet Date: 2017-04-26 Impact factor: 5.917