Bühler M, Binkert C, Exner G U
Department of Orthopedics, University of Zürich, Switzerland.
Arch Orthop Trauma Surg. 2001 Sep;121(8):458-61. doi: 10.1007/s004020100264.
Symptoms of osteoid osteoma are cured by removing the nidus. 'En-bloc' resection is often not successful because the nidus is hard to find and remove totally. Recently, minimally invasive procedures have been advocated for the resection of osteoid osteoma. Preceding investigators have used a set of special instruments. The nidus is best localized with computed tomography (CT). Surgery under CT control is only possible with minimal invasive procedures. A technique using standard equipment usually available in the operating room can be used successfully for CT-guided removal of the nidus. We report our preliminary results with 17 patients (12 men, 5 women) with an average age of 22 years (range 6-57 years). All patients were pain-free immediately after the operation. The average follow-up was 8.4 months (range 1-22 months) and the average operating time 75 min (range 50-130 min). Ten patients could be treated as outpatients. The average time in hospital after surgery was 1.5 days (range 1-3 days). There were two complications, one superficial wound infection and one change of operative technique to an open procedure due to a technical problem. The diagnosis could be confirmed histologically.
通过切除骨样骨瘤的瘤巢可治愈其症状。“整块”切除往往不成功,因为瘤巢难以找到且难以完全切除。近来,有人主张采用微创手术切除骨样骨瘤。先前的研究者使用了一套特殊器械。瘤巢最好通过计算机断层扫描(CT)定位。只有采用微创手术才有可能在CT控制下进行手术。一种使用手术室通常配备的标准设备的技术可成功用于CT引导下切除瘤巢。我们报告了17例患者(12例男性,5例女性)的初步结果,患者平均年龄22岁(范围6 - 57岁)。所有患者术后立即止痛。平均随访时间为8.4个月(范围1 - 22个月),平均手术时间为75分钟(范围50 - 130分钟)。10例患者可作为门诊病人治疗。术后平均住院时间为1.5天(范围1 - 3天)。有2例并发症,1例表浅伤口感染,1例因技术问题将手术技术改为开放手术。诊断可通过组织学证实。