Giant thoracic osteophyte: A distinct clinical entity

Abstract Calcified lesions described within the neural axis are classified as either an ossification of the posterior longitudinal ligament, diffuse idiopathic skeletal hyperostosis, or ossification of the ligamentum flavum. We aim to describe a unique pathologic entity: the giant thoracic osteophyt...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2014-09, Vol.21 (9), p.1599-1602
Main Authors: Coumans, Jean-Valery C.E, Neal, Jonathan B, Grottkau, Brian E, Nahed, Brian V, Shin, John H, Walcott, Brian P
Format: Article
Language:English
Subjects:
Adult
Arthrodesis
Degenerative disease
Female
Fusion
Humans
Imaging, Three-Dimensional
Intervertebral Disc - pathology
Middle Aged
Myelopathy
Neurology
Osteophyte
Osteophyte - complications
Osteophyte - pathology
Osteophyte - surgery
Retrospective Studies
Spinal Cord Compression - etiology
Spinal Cord Compression - surgery
Spine
Thoracic
Thoracic Vertebrae - pathology
Tomography, X-Ray Computed
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Summary:Abstract Calcified lesions described within the neural axis are classified as either an ossification of the posterior longitudinal ligament, diffuse idiopathic skeletal hyperostosis, or ossification of the ligamentum flavum. We aim to describe a unique pathologic entity: the giant thoracic osteophyte. We identified four patients who were surgically treated at the Massachusetts General Hospital from 2006 to 2012 with unusual calcified lesions in the ventral aspect of the spinal canal. In order to differentiate giant thoracic osteophytes from calcified extruded disc material, disc volumetrics were performed on actual and simulated disc spaces. All patients underwent operative resection of the calcific lesion as they had signs and/or symptoms of spinal cord compression. The lesions were found to be isolated, large calcific masses that originated from the posterior aspect of adjacent thoracic vertebral bodies. Pathological examination was negative for tumor. Adjacent disc volumes were not significantly different from the index disc ( p = 0.91). A simulated calculation hypothesizing that the calcific mass was extruded disc material demonstrated a significant difference ( p = 0.01), making this scenario unlikely. In conclusion, giant thoracic osteophyte is a unique and rare entity that can be found in the thoracic spine. The central tenant of surgical treatment is resection to relieve spinal cord compression.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2013.12.027