SURGICAL MANAGEMENT OF CERVICAL VERTEBRAE BONY SPACE OCCUPYING LESION-OSTEOID OSTEOMA

Abstract

16 YEAR OLD female was admitted with
complaints of neck pain radiating to right
upper limb in the form of electric shock
and aggravated by shoulder movements.
Clinical examination revealed right
elbow extensor and right wrist dorsiflexor
weakness. Right sided triceps jerk is diminished
without any sensory disturbances.
Right Plantar response is extensor.
CTMRI CERVICALSPINE showed
expansile osteosclerotic SOL involving
C7 RIGHT LAMINA,TRANSVERSE
PROCESS,PEDICLE and cord is pushed
to left side without any cord
changes.PRE OP CT AXIALPRE OP CT
SAGGITAL Posterior decompressive cervical
laminectomy C6,C7 on Right side
done , Bony Space Occupying Lesion
identified and drilled with electric drill. C7
ROOT decompressed and C7 spinal canal
widened with due care on cord and
similarly C6 root also decompressed with
due care on vertebral artery.
Postoperatively elbow and wrist
weakness improved and radicular pain
disappeared and right plantar response
became flexor.HPE REPORT CONSISTENT
WITH OSTEOID OSTEOMA. On
CONCLUSION, care must be taken on
operating bony Space occupying lesion
especially vertebral artery and cervical
cord. Moreover stabilisation is not required
as bony lesion involves only one
side and single dennis brown column.