Presentation
Neck pain and quadriparesis.
Patient Data
There is a posterior extradural benign-looking bony like lesion noted at C5 level apparently arising from the right lamina causing severe narrowing of the spinal canal, compressing the dorsal aspect of the thecal sac and spinal cord.
Small linear hyperintense T2 signal is seen in the cervical cord at the site of compression compatible with compressive myelopathy.
CT scan was performed after cervical spine MRI to further evaluate the bony lesion, and only limited study centered around C5-C6 level was done to reduce the radiation dose to the lowest possible dose.
There is a pedunculated bony lesion measuring about 1.6 x1.5 x1.2 cm arising from the inferomedial aspect of the right lamina of C5 causing severe compression of the posterior aspect of the thecal sac and spinal cord (extradural lesion).
The medullary cavity of the lesion and right lamina of C5 are continuous together.
Appearances are compatible with C5 posterior element exostosis.
Case Discussion
Spinal osteochondromas are rare, but when the spine is involved by exostosis cervical spine is most commonly involved part of the spine. It is believed that C2 is the most common vertebra to be involved by solitary osteochondroma.
For symptomatic patients with cord compression surgical removal of the osteochondroma is recommended.