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Eosinophilic Granuloma of the Spine

- See: Eosinophilic Granuloma - Discussion:

- 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;
                 - ABC
                 - 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;
          - Mucopolysaccharidosis;
          - Osteogenesis imperfecta;
          - Lymphoma;
          - Metastatic disease;

- X-ray:
    - 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:

- Biopsy:
    - 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.

Ewing's sarcoma simulating vertebra plana.

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