成人颈椎嗜酸性肉芽肿诊疗的研究进展  

Research progress in diagnosis and treatment of eosinophilic granuloma of the cervical spine in adults

作　　者：张宇 余城墙 吴有财 穆小平(综述) 韦建勋(审校)[1] ZHANG Yu;YU Cheng-qiang;WU You-cai(Department of Orthopaedics,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院骨科,南宁530021 [2]德国吉森大学附属医院神经脊柱外科,吉森35392

出　　处：《中国临床新医学》2021年第1期104-110,共7页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西自然科学基金-面上项目(编号:2016GXNSFAA380058)。

摘　　要：脊柱嗜酸性肉芽肿(EG)占所有骨肿瘤<1%,是自限性疾病,患者临床表现缺乏特异性,常表现为涉及椎体的溶骨性改变,多见于儿童,成人发病较少见。其首发症状多表现为局部疼痛,若累及颈椎可伴斜颈和活动受限,若病变累及脊髓或神经根时可导致神经功能损伤的表现,其特征性影像学表现是扁平椎,病理学特点为病变组织中有大量朗格汉斯细胞增生伴嗜酸性粒细胞、淋巴细胞浸润。而颈椎是脊柱EG的罕见位置,成人颈椎EG大多涉及单个椎体,少部分涉及多个椎体,颈部疼痛、四肢无力和运动受限是成人颈椎EG最常见的症状。随着对该病研究的不断深入,成人颈椎EG治疗方法也在不断更新,而手术通常用于严重神经功能缺损和骨骼不稳定的患者。Spinal eosinophilic granuloma(EG)accounts for less than 1%of all bone tumors.It is a self-limiting disease,and the clinical manifestations of the patients are lack of specificity.It often shows osteolytic changes involving the vertebral body,and is more common in children than in adults.The first symptom is mostly local pain.If the cervical spine is involved,torticollis and activity limitation can be accompanied.If the lesion involves spinal cord or nerve root,it may lead to neurological damage.The characteristic imaging manifestation is a flat vertebra.The pathological feature is a large number of Langerhans cell hyperplasia with eosinophil and lymphocyte infiltration in the lesion tissue.The cervical spine is a rare site of spinal EG.Adult cervical EG mostly involves a single vertebral body,and a small part involves multiple vertebral bodies.Neck pain,limb weakness and movement restriction are the most common symptoms of adult cervical EG.With the deepening of research on spinal EG,the treatments of adult cervical EG are also constantly updated,and surgery is usually performed in the patients with severe neurological deficits and bone instability.

关 键 词：脊柱嗜酸性肉芽肿 朗格汉斯细胞增多症 颈椎 成人 治疗 

分 类 号：R68[医药卫生—骨科学]