Osteochondroma of the dorsal spine presenting as thoracic myelopathy: A rare case report

Abstract

Osteochondroma is commonly found in the appendicular skeleton, though, relatively rarely, they occur in the spine, especially in the thoracic pedicle. A thorough radiographic workup is mandatory for a diagnosis. This is a case of a 13-year-old boy who developed gradual weakness over the lower limbs for the past 6 months, which worsened rapidly to 2/5 motor power over the last 3 weeks. A multidetector computed tomography suggested the diagnosis of a solitary osteochondroma of the D6 pedicle. Laminectomy and costotransversectomy with partial facetectomy and complete excision of the tumor with posterior instrumentation were done. Histopathological biopsy confirmed the tumor to be an osteochondroma. The power of the lower limbs improved postoperatively with physiotherapy to 3/5 at 6 weeks, 4/5 at 3-month follow-up, and 5/5 at 6-month follow-up. At 6-year follow-up, the patient is doing absolutely fine without any residual weakness or neurological deficit. Osteochondroma of the spine is rare. However, if they do occur, they usually need to be thoroughly investigated for accurate diagnosis and precise surgical treatment. These tumors could be presented with just a back pain or with progressing neurological deficits. A high index of suspicion and wide options of evaluation and management could change the course of the disease and the functional outcome of the patient.