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Primary Vertebral Tumors: A Review of Epidemiologic, Histological, and Imaging Findings, Part I: Benign Tumors

Ropper, Alexander E. MD*; Cahill, Kevin S. MD, PhD, MPH*; Hanna, John W. MD, PhD; McCarthy, Edward F. MD§; Gokaslan, Ziya L. MD; Chi, John H. MD, MPH*

doi: 10.1227/NEU.0b013e31822b8107
CNS University of Neurosurgery

Primary vertebral tumors, although less common than metastases to the spine, make up a heterogeneous group of neoplasms that can pose diagnostic and treatment challenges. They affect both the adult and the pediatric population and may be benign, locally aggressive, or malignant. An understanding of typical imaging findings will aid in accurate diagnosis and help neurosurgeons appreciate anatomic subtleties that may increase their effective resection. An understanding of the histological similarities and differences between these tumors is imperative for all members of the clinical team caring for these patients. In this first review of 2 parts, we discuss the epidemiological, histological, and imaging features of the most common benign primary vertebral tumors—aneurysmal bone cyst, chondroma and enchondroma, hemangioma, osteoid osteoma, and osteoblastoma—and lesions related to eosinophilic granuloma and fibrous dysplasia. In addition, we discuss the basic management paradigms for each of these diagnoses. In combination with part II of the review, which focuses on locally aggressive and malignant tumors, this article provides a comprehensive review of primary vertebral tumors.

Departments of *Neurosurgery and

Pathology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts

Departments of §Pathology and

Neurosurgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland

Correspondence: John H. Chi, MD, MPH, Department of Neurosurgery, Brigham and Women's Hospital, 15 Francis St, Boston, MA 02115. E-mail:

Received December 11, 2010

Accepted June 8, 2011

Copyright © by the Congress of Neurological Surgeons