Spinal stenosis frequent in children with multiple hereditary exostoses

Ali Ashraf, A. Noelle Larson, Gabriela Ferski, Cary H. Mielke, Nicholas M. Wetjen, Kenneth J. Guidera

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: Children with multiple hereditary exostoses (MHE) have numerous osteochondromas, with the most prominent lesions typically over the appendicular skeleton. A recent report noted a high rate of intracanal lesions in this patient population and recommended preventative spinal screening with magnetic resonance imaging (MRI) or computed tomography (CT). We sought to evaluate the prevalence of spinal stenosis from intracanal osteochondromas at our pediatric orthopedic center in order to evaluate if routine screening is warranted. Methods: All pediatric patients treated for MHE were retrospectively identified. Records were reviewed to determine demographics, previous orthopedic surgery, and indication and results of axial spine imaging (CT or MRI). Imaging studies were reviewed to evaluate the presence of intracanal and compressive spinal lesions. Results: Between 1990 and 2011, axial imaging was performed in nine patients with MHE due to concerns of pain, weakness, and/or dizziness. These patients had moderate disease involvement, with a mean of 4.9 previous orthopedic surgeries to address skeletal osteochondromas. Two patients with MHE had cervical spinal stenosis secondary to intracanal osteochondromas. Both children successfully underwent spinal decompression. Thus, of our MHE population undergoing axial imaging, 22 % were noted to have intracanal lesions. Conclusions: Our experience reveals a >20 % rate of compressive intracanal osteochondromas in MHE patients undergoing spinal imaging. These two patients represent 5 % of the MHE patients treated at our center. These lesions may be slow growing, and significant consequences can occur if not identified promptly. Thus, we confer that routine axial screening of the spinal canal may be warranted in these children.

Original languageEnglish (US)
Pages (from-to)183-194
Number of pages12
JournalJournal of Children's Orthopaedics
Volume7
Issue number3
DOIs
StatePublished - Jun 2013

Fingerprint

Multiple Hereditary Exostoses
Spinal Stenosis
Osteochondroma
Orthopedics
Tomography
Magnetic Resonance Imaging
Pediatrics
Spinal Canal
Dizziness
Decompression
Skeleton
Population
Spine
Demography
Pain

Keywords

  • CT
  • Imaging
  • MRI
  • Multiple hereditary exostoses
  • Neurologic symptoms
  • Pediatric
  • Spinal impingement

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Ashraf, A., Larson, A. N., Ferski, G., Mielke, C. H., Wetjen, N. M., & Guidera, K. J. (2013). Spinal stenosis frequent in children with multiple hereditary exostoses. Journal of Children's Orthopaedics, 7(3), 183-194. https://doi.org/10.1007/s11832-013-0484-9

Spinal stenosis frequent in children with multiple hereditary exostoses. / Ashraf, Ali; Larson, A. Noelle; Ferski, Gabriela; Mielke, Cary H.; Wetjen, Nicholas M.; Guidera, Kenneth J.

In: Journal of Children's Orthopaedics, Vol. 7, No. 3, 06.2013, p. 183-194.

Research output: Contribution to journalArticle

Ashraf, A, Larson, AN, Ferski, G, Mielke, CH, Wetjen, NM & Guidera, KJ 2013, 'Spinal stenosis frequent in children with multiple hereditary exostoses', Journal of Children's Orthopaedics, vol. 7, no. 3, pp. 183-194. https://doi.org/10.1007/s11832-013-0484-9
Ashraf, Ali ; Larson, A. Noelle ; Ferski, Gabriela ; Mielke, Cary H. ; Wetjen, Nicholas M. ; Guidera, Kenneth J. / Spinal stenosis frequent in children with multiple hereditary exostoses. In: Journal of Children's Orthopaedics. 2013 ; Vol. 7, No. 3. pp. 183-194.
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