Langerhans Cell Histiocytosis in the Pediatric Spine Requiring Stabilization: A Literature Review and Report of 3 Cases

JBJS Case Connect. 2023 Jun 15;13(2). doi: 10.2106/JBJS.CC.22.00450. eCollection 2023 Apr 1.

Abstract

Case: This report describes 3 cases of Langerhans cell histiocytosis (LCH) of the cervical and thoracic spine in patients aged 4 to 10 years. Each patient had painful lytic spinal lesions with vertebral body collapse and posterior involvement suggesting instability requiring corpectomy, grafting, and fusion. All 3 patients were doing well at their most recent follow-up without pain or recurrence.

Conclusion: Although LCH of the pediatric spine is usually successfully treated non-operatively, we recommend corpectomy and fusion when there is instability of the spinal column and/or severe stenosis. Posterior element involvement occurred in all 3 cases and may lead to instability.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Cartilage Diseases*
  • Child
  • Fractures, Spontaneous* / pathology
  • Histiocytosis, Langerhans-Cell* / complications
  • Histiocytosis, Langerhans-Cell* / diagnostic imaging
  • Histiocytosis, Langerhans-Cell* / surgery
  • Humans
  • Pain
  • Spinal Diseases* / diagnostic imaging
  • Spinal Diseases* / pathology
  • Spinal Diseases* / surgery
  • Spine / pathology
  • Vertebral Body