• 南京軍區(qū)南京總醫(yī)院骨科（南京，210002）;

【摘 要】 目的 探討胸腰椎椎體骨樣骨瘤患者的臨床表現(xiàn)特點(diǎn)和后路經(jīng)椎弓根腫瘤切除植骨內(nèi)固定手術(shù)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(xiàn)癥狀至就診時(shí)間為2～19個(gè)月，平均11.8個(gè)月。病灶節(jié)段：L2、L5各2例，L3、L4、T8和T10各1例。主要臨床表現(xiàn)為腰背部疼痛，1例存在下肢放射痛，4例合并脊柱側(cè)凸。病灶直徑0.9～2.0 cm，平均1.6 cm?；颊呔泻舐方?jīng)椎弓根椎體內(nèi)病灶刮除、打壓植骨、一期內(nèi)固定手術(shù)。 結(jié)果 手術(shù)時(shí)間70～170 min，平均110 min。術(shù)中出血量300～1 400 mL，平均720 mL。術(shù)后病理檢查均證實(shí)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(wú)并發(fā)癥發(fā)生。術(shù)后隨訪時(shí)間12～58個(gè)月，平均39個(gè)月。隨訪期間無(wú)腫瘤復(fù)發(fā)及脊柱畸形發(fā)生。 結(jié)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(xué)檢查方法；采用后路經(jīng)椎弓根椎體內(nèi)病灶刮除、打壓植骨、一期內(nèi)固定手術(shù)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(xiàn)和切除重建策略. 中國(guó)修復(fù)重建外科雜志, 2012, 26(1): 78-82. doi: 復(fù)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(yīng)用. 中國(guó)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. 1. system. Jpn J Radiol, 2011, 29(2): 138-143.
  2. 2. osteoid osteoma with conservative management: imaging correlation.
  3. 3. Skeletal Radiol, 2007, 36 Suppl 1: S72-S76.
  4. 4. ablation of spinal osteoid osteoma: clinical outcome. Spine (Phila Pa 1976), 2009, 34(9): 901-904.
  5. 5. and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng, 2011, 133(7): 071010.
  6. 6. CT guidance. Surg Neurol Int, 2011, 2: 31.
  7. 7. lumbar spine segment: a finite element analysis study. Biomed Mater Eng, 2010, 20(6): 349-359.
  8. 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. 9. Miyazaki M, Aoki J, Miyazaki A, et al. Percutaneous radiofrequency ablation of osteoid osteoma using cool-tip electrodes without the cooling.
  10. 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. 11. Jayakumar P, Harish S, Nnadi C, et al. Symptomatic resolution of spinal.
  12. 12. Vanderschueren GM, Taminiau AH, Obermann WR, et al. Osteoid osteoma: clinical results with thermocoagulation. Radiology, 2002, 224(1): 82-86.
  13. 13. Vanderschueren GM, Obermann WR, Dijkstra SP, et al. Radiofrequency.
  14. 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. 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. 16. Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics.
  17. 17. Thorat JD, Rajendra T, Thirugnanam A, et al. Single-stage posterior midline approach for dumbbell tumors of the thoracic spine, with intraoperative.
  18. 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. 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. 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(yīng)用. 中國(guó)脊柱脊髓雜志, 2006, 16(4): 263-266.
  21. 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. 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. 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.