Primary Bone Tumors Simulating Lumbar Disc Syndrome

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Of the more than 1000 patients seen at the Mayo Clinic with surgically proven bone tumor involving the vertebral column, thoracic cage, pelvis, or lower extremities, 38 had the preoperative diagnosis of protruded lumbar intervertebral disc. Of these 38 patients, 18 underwent myelography and laminectomy for disc protrusion, without relief of symptoms. Six others underwent laminectomy, at which time an osseous lesion was discovered. The remaining 14 patients had a negative myelogram, and the bone tumor became evident on roentgenogram after unsuccessful conservative treatment. Our data suggest that a clinical similarity exists between bone tumors and protruded lumbar intervertebral discs; intractable, progressive pain accentuated by the supine position favors the diagnosis of bone tumor. Bone tumors must be considered in the differential diagnosis of low-back pain and sciatica.

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