胸腰椎椎體骨樣骨瘤的臨床表現和切除重建策略_《中國修復重建外科雜志》

作者：

施鑫 , 任可 , 吳蘇稼 , 周光新 , 黎承軍 , 陸萌 , 趙建寧

南京軍區南京總醫院骨科（南京，210002）;

關鍵詞：

骨樣骨瘤胸腰椎診斷手術治療

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【摘要】目的探討胸腰椎椎體骨樣骨瘤患者的臨床表現特點和后路經椎弓根腫瘤切除植骨內固定手術的療效。方法 2001年1月－2010年6月，收治8例胸腰椎椎體骨樣骨瘤患者。男5例，女3例；年齡6～27歲，中位年齡15.5歲。出現癥狀至就診時間為2～19個月，平均11.8個月。病灶節段：L2、L5各2例，L3、L4、T8和T10各1例。主要臨床表現為腰背部疼痛，1例存在下肢放射痛，4例合并脊柱側凸。病灶直徑0.9～2.0 cm，平均1.6 cm。患者均行后路經椎弓根椎體內病灶刮除、打壓植骨、一期內固定手術。結果手術時間70～170 min，平均110 min。術中出血量300～1 400 mL，平均720 mL。術后病理檢查均證實為骨樣骨瘤。患者切口均Ⅰ期愈合，腰背疼痛和下肢放射痛均完全消退，無并發癥發生。術后隨訪時間12～58個月，平均39個月。隨訪期間無腫瘤復發及脊柱畸形發生。結論 CT能顯示椎體骨樣骨瘤低密度瘤巢和周圍的骨硬化帶，是胸腰椎椎體骨樣骨瘤重要影像學檢查方法；采用后路經椎弓根椎體內病灶刮除、打壓植骨、一期內固定手術可獲得較好療效。

引用本文： 施鑫 ,任可,吳蘇稼,周光新,黎承軍,陸萌,趙建寧. 胸腰椎椎體骨樣骨瘤的臨床表現和切除重建策略. 中國修復重建外科雜志, 2012, 26(1): 78-82. doi: 復制

1.	system. Jpn J Radiol, 2011, 29(2): 138-143.
2.	osteoid osteoma with conservative management: imaging correlation.
3.	Skeletal Radiol, 2007, 36 Suppl 1: S72-S76.
4.	ablation of spinal osteoid osteoma: clinical outcome. Spine (Phila Pa 1976), 2009, 34(9): 901-904.
5.	and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng, 2011, 133(7): 071010.
6.	CT guidance. Surg Neurol Int, 2011, 2: 31.
7.	lumbar spine segment: a finite element analysis study. Biomed Mater Eng, 2010, 20(6): 349-359.
8.	Gasbarrini A, Cappuccio M, Bandiera S, et al. Osteoid osteoma of the mobile spine: surgical outcomes in 81 patients. Spine (Phila Pa 1976), 2011, 36(24): 2089-2093.
9.	Miyazaki M, Aoki J, Miyazaki A, et al. Percutaneous radiofrequency ablation of osteoid osteoma using cool-tip electrodes without the cooling.
10.	Burn SC, Ansorge O, Zeller R, et al. Management of osteoblastoma and osteoid osteoma of the spine in childhood. J Neurosurg Pediatr, 2009, 4(5): 434-438.
11.	Jayakumar P, Harish S, Nnadi C, et al. Symptomatic resolution of spinal.
12.	Vanderschueren GM, Taminiau AH, Obermann WR, et al. Osteoid osteoma: clinical results with thermocoagulation. Radiology, 2002, 224(1): 82-86.
13.	Vanderschueren GM, Obermann WR, Dijkstra SP, et al. Radiofrequency.
14.	Peyser AB, Makley JT, Callewart CC, et al. Osteoma of the long bones and the spine. A study of eleven patients and a review of the literature. J Bone Joint Surg (Am), 1996, 78(8): 1172-1180.
15.	Matsumura A, Namikawa T, Terai H, et al. The influence of approach side on facet preservation in microscopic bilateral decompression via a unilateral approach for degenerative lumbar scoliosis. Clinical article. J Neurosurg Spine, 2010, 13(6): 758-765.
16.	Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics.
17.	Thorat JD, Rajendra T, Thirugnanam A, et al. Single-stage posterior midline approach for dumbbell tumors of the thoracic spine, with intraoperative.
18.	Tian NF, Xu HZ, Wang XY, et al. Morphometric comparisons between the pedicle and the pedicle rib unit in the immature Chinese thoracic spine: a computed tomographic assessment. Spine (Phila Pa 1976), 2010, 35(16): 1514-1519.
19.	Zindrick MR, Knight GW, Sartori MJ, et al. Pedicle morphology of the immature thoracolumbar spine. Spine (Phila Pa 1976), 2000, 25(21): 2726-2735.
20.	陳立言, 彭新生, 李佛保, 等. 椎弓根釘固定在10歲以下小兒胸腰椎疾患治療中的應用. 中國脊柱脊髓雜志, 2006, 16(4): 263-266.
21.	Li Y, Lewis G. Influence of loading cycle profile and frequency on a biomechanical parameter of a model of a balloon kyphoplasty-augmented.
22.	Jain S, Modi HN, Suh SW, et al. Pedicle shifting or migration as one of the causes of curve progression after posterior fusion: an interesting case report and review of literature. J Pediatr Orthop B, 2009, 18(6): 369-374.
23.	Kawahara C, Tanaka Y, Kato H, et al. Myolysis of the erector spinae muscles as the cause of scoliosis in osteoid osteoma of the spine. Spine (Phila Pa 1976), 2002, 27(12): E313-315.

1. system. Jpn J Radiol, 2011, 29(2): 138-143.
2. osteoid osteoma with conservative management: imaging correlation.
3. Skeletal Radiol, 2007, 36 Suppl 1: S72-S76.
4. ablation of spinal osteoid osteoma: clinical outcome. Spine (Phila Pa 1976), 2009, 34(9): 901-904.
5. and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng, 2011, 133(7): 071010.
6. CT guidance. Surg Neurol Int, 2011, 2: 31.
7. lumbar spine segment: a finite element analysis study. Biomed Mater Eng, 2010, 20(6): 349-359.
8. Gasbarrini A, Cappuccio M, Bandiera S, et al. Osteoid osteoma of the mobile spine: surgical outcomes in 81 patients. Spine (Phila Pa 1976), 2011, 36(24): 2089-2093.
9. Miyazaki M, Aoki J, Miyazaki A, et al. Percutaneous radiofrequency ablation of osteoid osteoma using cool-tip electrodes without the cooling.
10. Burn SC, Ansorge O, Zeller R, et al. Management of osteoblastoma and osteoid osteoma of the spine in childhood. J Neurosurg Pediatr, 2009, 4(5): 434-438.
11. Jayakumar P, Harish S, Nnadi C, et al. Symptomatic resolution of spinal.
12. Vanderschueren GM, Taminiau AH, Obermann WR, et al. Osteoid osteoma: clinical results with thermocoagulation. Radiology, 2002, 224(1): 82-86.
13. Vanderschueren GM, Obermann WR, Dijkstra SP, et al. Radiofrequency.
14. Peyser AB, Makley JT, Callewart CC, et al. Osteoma of the long bones and the spine. A study of eleven patients and a review of the literature. J Bone Joint Surg (Am), 1996, 78(8): 1172-1180.
15. Matsumura A, Namikawa T, Terai H, et al. The influence of approach side on facet preservation in microscopic bilateral decompression via a unilateral approach for degenerative lumbar scoliosis. Clinical article. J Neurosurg Spine, 2010, 13(6): 758-765.
16. Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics.
17. Thorat JD, Rajendra T, Thirugnanam A, et al. Single-stage posterior midline approach for dumbbell tumors of the thoracic spine, with intraoperative.
18. Tian NF, Xu HZ, Wang XY, et al. Morphometric comparisons between the pedicle and the pedicle rib unit in the immature Chinese thoracic spine: a computed tomographic assessment. Spine (Phila Pa 1976), 2010, 35(16): 1514-1519.
19. Zindrick MR, Knight GW, Sartori MJ, et al. Pedicle morphology of the immature thoracolumbar spine. Spine (Phila Pa 1976), 2000, 25(21): 2726-2735.
20. 陳立言, 彭新生, 李佛保, 等. 椎弓根釘固定在10歲以下小兒胸腰椎疾患治療中的應用. 中國脊柱脊髓雜志, 2006, 16(4): 263-266.
21. Li Y, Lewis G. Influence of loading cycle profile and frequency on a biomechanical parameter of a model of a balloon kyphoplasty-augmented.
22. Jain S, Modi HN, Suh SW, et al. Pedicle shifting or migration as one of the causes of curve progression after posterior fusion: an interesting case report and review of literature. J Pediatr Orthop B, 2009, 18(6): 369-374.
23. Kawahara C, Tanaka Y, Kato H, et al. Myolysis of the erector spinae muscles as the cause of scoliosis in osteoid osteoma of the spine. Spine (Phila Pa 1976), 2002, 27(12): E313-315.

《中國修復重建外科雜志》

胸腰椎椎體骨樣骨瘤的臨床表現和切除重建策略

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《中國修復重建外科雜志》

胸腰椎椎體骨樣骨瘤的臨床表現和切除重建策略

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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