- See: Eosinophilic Granuloma - Discussion:
- most common in the thoracic spine;
- may present with progressive back pain;
- vertebra plana:
- in 2-6 yrs old child, EOG may present w/ collapse of single vertebra;
- diff dx of single level collapse:
- ewing's sarcoma;
- osteomyelitis (look for loss of disc height);
- ref: Vertebra plana of the lumbar spine caused by an ABC: a case report.
- collpase of multiple vertebra implies:
- Gaucher's disease;
- Osteogenesis imperfecta;
- Metastatic disease;
- on lateral views, look for vertebral flattening (vertebra plana) which is a precursor to collapse;
- note that non Hodgkin lymphoma of the spine may cause a compression fracture may give the
appearance of vertebra plana;
- always consider osteomyelitis of spine:
- may be required for diagnosis unless the radiographic picture is
classic or histiocytosis has already been diagnosed;
- Non Operative Treatment:
- lesion is usually self-limiting;
- at least 50% reconstitution of vertebral height may be expected;
- if there is no neurological deficit, lesion may be followed non operatively;
- even w/ non-myelopathic neurological signs (numbness or weakness), bracing will often lead to resolution of symptoms;
- bracing may also be used to prevent progressive kyphosis;
- chemotherapy: is useful for the systemic form of disease;
- low dose XRT:
- may be indicated w/ neurologic deficits, esp if surgical decompression is not possible;
- low-dose irradiation of the lesion (500 to 900 rads) is used
- Operative Treatment:
- w/ severe neurologic deficit, surgical decompression & arthrodesis is indicated
Eosinophil granuloma of the spine.
Eosinophilic granuloma of the spine with and without vertebral plana: long term follow up of six cases.
Vertebra plana and eosinophilic granuloma of the cervical spine in children.
Vertebra plana. Long-term follow-up in five patients.