Projects

Osteochondromas are usually found in the long
bones of patients with hereditary multiple exostoses (HME).
The spine is reported to be involved in over 50% of cases,
but few of these patients are symptomatic as the result of an
existing spinal exostosis.
Methods We reviewed the current literature in order to find
the right approach to patients with HME-complicated spinal
exostosis and describe three paediatric patients that were diagnosed
late with spinal cord compression due to cervical
exostosis.
Results Our three cases were all late presentations with
neurology and unfortunately had minimal improvement of
neurology after the lesion was surgically removed. There is
general agreement that late presentation of spinal cord injury
due to osteochondromas involving the cervical spine may
cause severe and irreversible neurological sequelae. Our literature
review revealed that there are no clear-cut guidelines to
develop more comprehensive screening measures for these
patients.
Conclusion A high index of suspicion is the most important
factor for correct diagnosis and appropriate management.
Physicians who treat HME should bear in mind that thorough
history taking and a neurological examination at follow up
are essential for these patients. Clearer guidelines for the development
of more comprehensive screening programmes
are essential.