Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2012
[Clinical manifestation and strategy for surgical resection and reconstruction of thoracolumbar vertebral osteoid osteoma].
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Shi Xin, Ren Ke, Wu Sujia, Zhou Guangxin, Li Chenguin, Lu Meng, Zhao Jianning
Аннотация
OBJECTIVE: To investigate the clinical manifestation of thoracolumbar vertebral osteoid osteoma and to evaluate the surgical procedure and effectiveness of transpedicular tumor resection and spine reconstruction with posterior pedicle screw system and bone graft.
METHODS: Between January 2001 and June 2010, 8 cases of thoracolumbar vertebral osteoid osteoma underwent one-stage transpedicular intralesional excision and bone graft combined with spine reconstruction with pedicle screw system through posterior approach. There were 5 males and 3 females with a median age of 15.5 years (range, 6-27 years). Affected segments included T8 in 1 case, T10 in 1 case, L2 in 2 cases, L3 in 1 case, L4 in 1 case, and L5 in 2 cases. All of the cases had back pain, 1 had radiating pain of lower extremity, and 4 patients presented with scoliosis. The mean diameter of lesions was 1.6 cm (range, 0.9-2.0 cm).
RESULTS: The mean operation time was 110 minutes (range, 70-170 minutes) and the mean blood loss was 720 mL (range, 300-1 400 mL). The postoperative pathologic examination showed osteoid osteoma in all cases. All patients achieved healing of the incisions by first intention. Immediate relief of pain was observed after operation in all patients without complication. The patients were followed up 12-58 months (mean, 39 months). No local recurrence or spinal deformity was observed during the follow-up.
CONCLUSION: CT can show a low attenuation nidus with central mineralization and varying degrees of perinidal sclerosis, so it has great value for final diagnosis of thoracolumbar vertebral osteoid osteoma. One-stage transpedicular intralesional excision supplemented by impaction bone graft and combined posterior pedicle screw stabilization is a safe and effective treatment.
METHODS: Between January 2001 and June 2010, 8 cases of thoracolumbar vertebral osteoid osteoma underwent one-stage transpedicular intralesional excision and bone graft combined with spine reconstruction with pedicle screw system through posterior approach. There were 5 males and 3 females with a median age of 15.5 years (range, 6-27 years). Affected segments included T8 in 1 case, T10 in 1 case, L2 in 2 cases, L3 in 1 case, L4 in 1 case, and L5 in 2 cases. All of the cases had back pain, 1 had radiating pain of lower extremity, and 4 patients presented with scoliosis. The mean diameter of lesions was 1.6 cm (range, 0.9-2.0 cm).
RESULTS: The mean operation time was 110 minutes (range, 70-170 minutes) and the mean blood loss was 720 mL (range, 300-1 400 mL). The postoperative pathologic examination showed osteoid osteoma in all cases. All patients achieved healing of the incisions by first intention. Immediate relief of pain was observed after operation in all patients without complication. The patients were followed up 12-58 months (mean, 39 months). No local recurrence or spinal deformity was observed during the follow-up.
CONCLUSION: CT can show a low attenuation nidus with central mineralization and varying degrees of perinidal sclerosis, so it has great value for final diagnosis of thoracolumbar vertebral osteoid osteoma. One-stage transpedicular intralesional excision supplemented by impaction bone graft and combined posterior pedicle screw stabilization is a safe and effective treatment.