Osteochondroma Arising from Dorsal Pedicle Causing Compressive Myelopathy

Introduction: Osteochondromas are benign bony neoplasms typically located in long bones, though they may occasionally occur in the posterior elements of the spine. Case Report: We present a case of a 10-year-old boy with multiple osteochondromas diagnosed with hereditary multiple exostoses, who exhibited symptoms of thoracic myelopathy. Radiological investigations indicated a heterogeneous mass on magnetic resonance imaging (MRI) that was encroaching upon the spinal canal. The computed tomography scan verified the presence of a pedunculated exostosis originating from the right D4 pedicle. The mass was excised through a right lateral extracavitary approach and sent for histopathological examination, which confirmed the diagnosis. The patient exhibited improvement and achieved full recovery within 6 months. Conclusion: Osteochondromas of the spine are infrequently symptomatic. Early diagnosis with clinical features and MRI will help to initiate treatment.