Paraparesis caused by rib exostosis in a child with Down syndrome: a case report

Case report. We describe a case of paraparesis caused by a rib exostosis compressing the spinal cord. Exostoses are the most common benign tumors of bone and often arise from the metaphyses of long bones. Spinal exostoses are uncommon lesions, but when present, may compress the spinal cord and cause...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2008-11, Vol.33 (23), p.E911-E913
Main Authors: Mannoji, Chikato, Yamazaki, Masashi, Kamegaya, Makoto, Saisu, Takashi, Minami, Shohei, Takahashi, Kazuhisa
Format: Article
Language:English
Subjects:
Bone Neoplasms - complications
Bone Neoplasms - pathology
Bone Neoplasms - surgery
Child
Down Syndrome - complications
Down Syndrome - pathology
Exostoses - complications
Exostoses - pathology
Exostoses - surgery
Humans
Magnetic Resonance Imaging
Male
Osteochondroma - complications
Osteochondroma - pathology
Osteochondroma - surgery
Paraparesis - etiology
Paraparesis - pathology
Paraparesis - surgery
Ribs - pathology
Spinal Cord Compression - etiology
Spinal Cord Compression - pathology
Spinal Cord Compression - surgery
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Case report. We describe a case of paraparesis caused by a rib exostosis compressing the spinal cord. Exostoses are the most common benign tumors of bone and often arise from the metaphyses of long bones. Spinal exostoses are uncommon lesions, but when present, may compress the spinal cord and cause significant neurologic symptoms. Spinal exostoses leading to neurologic impairment typically arise from vertebrae or laminae. It is very rare for exostoses originating from rib heads to cause neurologic symptoms. The patient's medical and radiographic history is reviewed as well as the relevant medical literature. A 10-year-old boy with multiple exostoses and Down syndrome was referred to our hospital because of difficulty walking. Careful physical examination revealed that his gait disturbance was because of paraparesis. Radiographs, computed tomography scan, and magnetic resonance imaging revealed that an exostosis arising from the left eighth rib head was compressing the spinal cord. The exostosis was resected and the patient's neurologic symptoms resolved. Exostosis rising from the rib head can compress the spinal cord and cause neurologic deficits. Surgical resection of the rib exostosis should be strongly considered when neurologic symptoms develop.
ISSN:0362-2436
1528-1159
DOI:10.1097/BRS.0b013e3181845b56