脊柱骨母细胞瘤的手术治疗体会  

Surgical Treatment of Spinal Oteoblastoma

作　　者：尹之玮 唐六一 胡豇[2] 俞阳[2] 林书[2] Yin Zhwei;Tang Liuyi;Hu Jiang(Southwest Medical Universiy Luzhou,Sichuan 646000;Department of Orthopedics,Sichuan Academy of Medical Science,People's Hospital of Sichuan Province Chengdu,Sichuan 610072,China)

机构地区：[1]西南医科大学,四川泸州646000 [2]四川省医学科学院·四川省人民医院骨科,四川成都610072

出　　处：《四川医学》2024年第4期343-346,共4页Sichuan Medical Journal

基　　金：四川省科技厅支撑项目(编号:2022YFS0018,2022YFS0019)。

摘　　要：目的 探讨脊柱骨母细胞瘤不同手术治疗术式的临床效果。方法 选取2016年1月至2022年1月我院收治的脊柱骨母细胞瘤患者16例,其中男7例,女9例,年龄12~61岁,平均24.9岁。病变位于颈椎2例、胸椎10例、腰椎4例。症状以局部疼痛为主,昼夜不分明。2例伴有神经症状,均为胸椎病变病例,Frankel C级1例,Frankel D级1例。肿瘤按Enneking分期:Ⅱ期10例,Ⅲ期6例。手术方式:Ⅱ期行扩大切除术,Ⅲ期行全脊椎切除术。结果 全部病例得到随访,随访时间12~60个月,平均25.8个月。无术后切口感染、脑脊液漏,无术后神经症状加重,1例Frankel D级病例神经功能术后改善为Frankel E级,1例Frankel C级术后改善为Frankel D级。所有病例末次随访经检查症状体征及影像学CT、MRI肿瘤均未复发。结论 脊柱骨母细胞瘤应按中间性肿瘤(局部浸润型)对待,手术治疗防止术后肿瘤复发是关键。外科手术对Enneking分期Ⅱ期病例行肿瘤扩大切除术、Ⅲ期行全脊椎切除术可以防止术后肿瘤复发,得到满意临床效果。Objective To investigate clinical effects of different surgical procedures for spinal osteoblastoma.Methods From January 2016 to January 2022,16 patients with osteoblastoma of spine were treated in our hospital,including 7 males and 9 females,aged 12~61 years(mean 24.9 years).The lesions were located in cervical vertebrae(2 cases),thoracic vertebrae(10 cases)and lumbar vertebrae(4 cases).The main symptoms were local pain,which was not clear day and night.2 cases with neurological symptoms were found in thoracic spine,Frankel C 1 case and Frankel D 1 case.According to Enneking staging,10 cases were stage Ⅱ and 6 cases were stage Ⅲ.The operative methods were extended resection in stage Ⅱ and total spondylectomy in stage Ⅱ.Results All patients were followed up for 12~60 months(mean 25.8 months).Postoperative wound infection and cerebrospinal fluid leakage were not found.Neurological symptoms were not aggravated.For neurological function,Frankel D grade was improved to Frankel E grade in one case,and Frankel C grade was improved to Frankel D grade in one case.No recurrence was found in all cases after follow-up.Conclusion Osteoblastoma of spine should be treated as an intermediate tumor(locally infiltrating type),and surgical treatment to prevent postoperative tumor recurrence is key.The extended resection of tumor in Enneking stage I and total spondylectomy in Enneking stage II could prevent tumor recurrence and obtain satisfactory clinical results.

关 键 词：脊柱骨母细胞瘤 手术治疗 Enneking分期 临床疗效 

分 类 号：R738.1[医药卫生—肿瘤]