活动节段脊柱动脉瘤样骨囊肿的外科治疗及预后分析  

Surgical treatment and prognosis of aneurysmal bone cyst in mobile spine

作　　者：杨诚[1] 马俊明[1] 杨墨松[1] 肖建如[1] 杨兴海[1] 贾连顺[1] 袁文[1] 

机构地区：[1]第二军医大学长征医院骨科,上海200003

出　　处：《中华外科杂志》2008年第8期584-587,共4页Chinese Journal of Surgery

摘　　要：目的研究脊柱动脉瘤样骨囊肿（ABC）的临床特点，探讨外科手术治疗及其预后。方法对1996年至2006年接受手术治疗的12例活动节段脊柱的ABC患者的临床资料进行回顾性分析。依据肿瘤的WBB分期，实施全椎节切除7例，矢状切除1例，后弓切除4例。分别采用前后联合入路或后外侧入路行肿瘤切除、植骨或骨水泥椎体重建、椎弓根内固定术。术后对8例行放疗。结果术中平均出血量为3210ml，随访10～116个月，平均41．8个月。7例脊髓神经功能完全恢复，4例术后1～2年局部复发，1例放疗后恶变成软骨肉瘤并多处转移后死亡。结论脊柱ABC临床较少见，常呈侵袭性生长易复发。术中尽量做到肉眼下彻底切除肿瘤，能有效改善神经症状并降低局部复发率。术后辅助局部放疗可降低复发率。Objective To investigate the effects of surgical treatment and prognosis of aneurysmal bone cyst （ABC） in mobile spine. Methods A total of 12 patients with ABC were operated on from 1996 to 2006, and the clinical data were retrospectively reviewed. The patients included 7 male and 5 female, aged from 16 to 52 years （mean, 29 years）. Surgical interventions were selected according to WBB criteria. Seven patients underwent total spendylectomy, four underwent resection of posterior arch, one patient received sagital resection only. Anti-pester or pest-lateral approach reconstruction with bone-graft or bone cement and transpedicular screws fixation were performed in the cases. Eight cases received radiotherapy after the operation. Results The mean operation blood lose was 3210 ml. The patients were followed-up for 10 to 116 months （mean, 41.8 months）. Seven patients got complete recover of spinal cord function, 4 patients experienced local recurrence in 1-2 years pest operation. One patient died of multiple metastasis of chondrosacoma after radiotherapy. Conclusions ABC in spine is an aggressive disease with high local recurrence rate. Enbloc if possible provides the best result, with excellent prognosis. Radiotherapy should be selected carefully.

关 键 词：骨囊肿 动脉瘤样 脊柱 外科手术 预后 

分 类 号：R686[医药卫生—骨科学]