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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1814148
Review Article

Nonsyndromic Osteochondroma of Lumbar Spine: A Systematic Review of Management and Outcomes with Illustrative Case

Authors

  • Sadegh Bagherzadeh

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
    2   Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
    3   Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Mohsen Rostami

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Mohammad Jafari

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Faramarz Roohollahi

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
    3   Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Srujan Kopparapu

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • P. Mitchell Johansen

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Gersham Rainone

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Jay Kumar

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Mark Greenberg

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Puya Alikhani

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States
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Abstract

Osteochondromas (OCs) are the most common benign bone tumors, but rarely arise in the lumbar spine. Due to their infrequency, understanding of their clinical presentation, management, and outcomes is limited, with most available data derived from case reports and small series. This systematic review aims to synthesize the literature on nonsyndromic lumbar spine OCs and to present an illustrative institutional case. A systematic search was conducted in PubMed, Embase, Web of Science, and Scopus from database inception to April 2024, following PRISMA 2020 guidelines. Studies reporting clinical cases or series of nonsyndromic lumbar spine OCs with sufficient details on presentation, tumor characteristics, management, and outcomes were included. The risk of bias was evaluated using the Joanna Briggs Institute tools for case reports and case series. Data extraction encompassed demographics, clinical characteristics, tumor features, operative management, and postoperative outcomes. A total of 39 studies encompassing 56 patients were included. The mean age was 42 years; 59% were male. Most lesions originated from the inferior articular process (43%) and commonly affected L4 and L5. The mean lesion size was 29.7 ± 22.2 mm, with significantly smaller lesions in patients with radiculopathy than those with low back pain or palpable mass (p = 0.00034). Radiculopathy (50%) and low back pain (25%) were the most frequent presentations (p < 0.001). The majority (80%) underwent posterior surgical excision without instrumentation, with en bloc resection performed in 78.5%. Complete symptomatic improvement was observed in 94% of patients, and recurrence was rare. Lumbar spine OCs most frequently arise from the inferior articular process and often produce radiculopathy due to intracanalicular growth. Surgical excision—especially en bloc resection—yields excellent outcomes and a low recurrence rate. Conservative treatment may be considered in selected asymptomatic patients. Early recognition and individualized management are essential for optimal outcomes.

Keywords

OC - spinal neoplasms - case reports - lumbar vertebrae - review

Note

The PROSPERO registration code is CRD420251119471.


Authors' Contributions

The conception and design of the study were performed by S.B., M.R., and F.R.. M.R. provided administrative support. M.R. and F.R. handled study materials and patient recruitment, also contributing to data collection and assembly. S.B., M.J., J.K., and S.K. performed data analysis and interpretation. P.J., S.B., and G.R. wrote the manuscript. P.A., M.G., and M.R. performed critical revision. All authors gave final approval of the manuscript.


Ethical Approval

Our institution's ethical committee waived the requirement for ethical approval for this case report, as it was deemed part of standard patient care.


Patients' Consent

The patient provided both verbal and informed written consent for the use of his clinical data and images in this case report; the manuscript and images do not disclose the patient's identity.




Publication History

Article published online:
09 December 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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