Enlargement of an osseous loose body in the cervical spine with cord compression

Abstract

Background context Loose bodies in the spinal canal are extremely rare, with only two cases reported previously in the literature. Purpose To report a rare case of an osseous loose body in the cervical spine with radiographic evidence of dramatic enlargement of the loose body in the spinal canal over the course of 9 years. Study design/setting Case report. Patient sample A 50-year-old man presented with progressive numbness and weakness of the upper and lower extremities and swaying gait in 2007. He had a history of temporary incomplete tetraplegia after a fall in 1998. Magnetic resonance imaging revealed enlargement of the posterior mass-occupying lesion compressing the cord at C5–C6 over the course of 9 years. Outcome measures Neurological examination with motor and sensory status. Results Posterior decompressive laminectomy was performed. An isolated, smooth-surfaced, bony, hard mass was found between the ligamentum flavum and facet joint and removed. Histological examination demonstrated trabecular bone and peripheral cartilage mixed with fibrous and fibrocartilaginous tissue. Clinical evaluation of the patient 6 months postoperatively showed total resolution of neurological symptoms. Conclusion We report herein an extremely rare case of an osseous loose body in the spinal canal with cord compression. This report represents the first documented case of growth of a loose body in the spinal canal.