Neurologic recovery following laminectomy and tumor resection of a pediatric cervical synovial osteochondromatosis causing paralysis

• Published in: European spine journal 2024-07, Vol.33 (7), p.2904-2908
• Main Authors: Yamauchi, Ippei, Nakashima, Hiroaki, Inoue, Taro, Nojima, Takayuki, Imagama, Shiro
• Format: Article
• Language: English
• Subjects: Biopsy; Bone surgery; Case Report; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Child; Chondromatosis, Synovial - diagnostic imaging; Chondromatosis, Synovial - surgery; Computed tomography; Differential diagnosis; Humans; Laminectomy - methods; Magnetic Resonance Imaging; Male; Malignancy; Medicine; Medicine & Public Health; Neurosurgery; Paralysis; Paralysis - etiology; Paralysis - surgery; Pediatrics; Recovery of Function; Spinal cord; Spinal Cord Compression - diagnostic imaging; Spinal Cord Compression - etiology; Spinal Cord Compression - surgery; Spine (cervical); Surgical Orthopedics; Treatment Outcome; Tumors
• ISSN: 0940-6719; 1432-0932; 1432-0932
• DOI: 10.1007/s00586-024-08304-8

Purpose To report the surgical outcome of synovial osteochondromatosis, a rare tumor of the cervical spine, in a 6-year-old boy. Methods A 6-year-old boy presented with muscle weakness in the right deltoid (2) and biceps (4) during a manual muscle test. Magnetic resonance imaging showed a 3 × 2 × 1.5 cm mass within the spinal canal at the C4–6 level, compressing the cervical spinal cord from the right side. Computed tomography revealed hyperintense areas within the tumor and ballooning of the right C4–5 and C5–6 facet joints. Results After a biopsy confirmed the absence of malignancy, a gross total resection was performed. The pathological diagnosis of synovial osteochondromatosis was established. Postoperatively, muscle weakness improved fully in the manual muscle test, and there were no neurological findings after 3 months. However, the patient is under careful follow-up owing to the detection of a regrowth site within the right C4–5 and C5–6 intervertebral foramen 2 years postoperatively. Conclusions Synovial osteochondromatosis of the cervical spine in children is rare, and this is the first report of its regrowth after surgery. Synovial osteochondromatosis should be included in the differential diagnosis of pediatric cervical spine tumors.