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NEUROIMAGES
Year : 2019  |  Volume : 67  |  Issue : 5  |  Page : 1398

Thoracic Spinal Epidural Osteoma Presenting with Compressive Myelopathy


Department of Neurosurgery, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal

Date of Web Publication19-Nov-2019

Correspondence Address:
Dr. Sunil Munakomi
Department of Neurosurgery, Nobel Medical College and Teaching Hospital, Biratnagar - 56700
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.271238

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How to cite this article:
Munakomi S. Thoracic Spinal Epidural Osteoma Presenting with Compressive Myelopathy. Neurol India 2019;67:1398

How to cite this URL:
Munakomi S. Thoracic Spinal Epidural Osteoma Presenting with Compressive Myelopathy. Neurol India [serial online] 2019 [cited 2019 Dec 13];67:1398. Available from: http://www.neurologyindia.com/text.asp?2019/67/5/1397/271238




A 55-year-old male patient presented to our outpatient clinic with a history of progressive weakness of his bilateral lower limbs since last 1 month. There was no history of trauma, fever, significant weight loss, sensory loss, altered bladder or bowel symptoms, or any previous such incidents in the past. On neurological examination, power in his lower limbs were Modified Rankin Scale grade 1/5 with pain, temperature, vibration modalities suspended to the T4 dermatome region. His anal tone was intact. He had hypertonia in bilateral lower limbs with presence of clonus. His magnetic resonance imaging (MRI) spine revealed an anteriolateral epidural lesion causing significant compression of the cord at T6 region [Figure 1]. An introperative O-arm was used to localize the lesion [Figure 2]. Thoracic laminectomy revealed a solid bony lesion compressing upon the cord which was carefully drilled until the the cord was thoroughly lax and decompressed. Histology was suggestive of osteoma [Figure 3]. Though the patient showed no obvious clinical improvement, he was advised for continuous physiotherapy.
Figure 1: MRI sequences revealing a thoracic epidural lesion compressing upon

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Figure 2: Intraoperative multiplanar O-arm images of the lesion

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Figure 3: Histology picture was suggestive of osteoma

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Spinal epidural osteoma presenting with features of myelopathy is an extremely rare entity.[1] Though benign and slowly progressive, it can present with compressive myelopathy. Early diagnosis and optimal resection is the recommended therapeutic target.[1]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Wang W, Kong L, Dong R, Zhao H, Ma Y, Lu Y. Osteoma in the upper cervical spine with spinal cord compression. Eur Spine J 2006;15(Suppl 5):616-20.  Back to cited text no. 1
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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