Hadjipavlou Alexander G, Lander Philip H, Marchesi Dante, Katonis Pavlos G, Gaitanis Ioannis N
Department of Orthopaedic Traumatology, University of Crete, School of Medicine, Heraklion, Crete, Greece.
Spine (Phila Pa 1976). 2003 Nov 15;28(22):E472-7. doi: 10.1097/01.BRS.0000092386.96824.DB.
Compare the effectiveness of two different techniques for the management of osteoid osteoma of the spine.
To describe the technique, feasibility, and indications of two different minimally invasive surgical methods for the treatment of osteoid osteoma of the spine.
Current treatment of osteoid osteoma of the spine is usually conventional surgical excision. The successful treatment of osteoid osteoma of the appendicular skeleton by percutaneous radiofrequency probe ablation is known; however, there have been only a few cases reported utilizing this method to treat osteoid osteoma of the spine. The high success rate of percutaneous transpedicle vertebral biopsy and diskectomy led us to believe this technique can also be applicable for the treatment of osteoid osteoma of the spine.
Two patients with symptomatic osteoid osteoma of the spine underwent two different surgical managements with local anesthesia. In one patient, the osteoid osteoma was localized in the apex of the right L4 superior articular process joint. Under computed tomography guidance he underwent radiofrequency coagulation with the use of a radiofrequency generator at 90 degrees for 240 seconds. The lesion in the second patient was located in the right pedicle of the T9 vertebra close to the exiting nerve root and was cored out by means of a special percutaneous instrument designed for percutaneous biopsy under fluoroscopic guidance.
Both patients experienced immediate relief of pain, resumed their regular activities, and also remained free of symptoms after the 2.5- and 3-year follow-up.
Minimally invasive surgery can successfully be applied in the treatment of osteoid osteoma of the lumbar spine. When the nidus is not adjacent to the neural elements radiofrequency thermal ablation can be an effective and safe treatment of osteoid osteoma in the spine.
比较两种不同技术治疗脊柱骨样骨瘤的有效性。
描述两种不同的微创手术方法治疗脊柱骨样骨瘤的技术、可行性及适应证。
目前脊柱骨样骨瘤的治疗通常采用传统手术切除。经皮射频探头消融治疗四肢骨样骨瘤已获成功；然而，仅有少数病例报道采用该方法治疗脊柱骨样骨瘤。经皮椎弓根椎体活检及椎间盘切除术的高成功率使我们相信该技术也可应用于脊柱骨样骨瘤的治疗。
两名有症状的脊柱骨样骨瘤患者在局部麻醉下接受了两种不同的手术治疗。一名患者的骨样骨瘤位于右L4上关节突关节的顶点。在计算机断层扫描引导下，他使用射频发生器以90度进行了240秒的射频凝固。第二名患者的病变位于T9椎体右椎弓根靠近出神经根处，在透视引导下通过一种专为经皮活检设计的特殊经皮器械将其取出。
两名患者均立即缓解了疼痛，恢复了日常活动，在2.5年和3年的随访后也均无症状。
微创手术可成功应用于腰椎骨样骨瘤的治疗。当病灶不邻近神经结构时，射频热消融可成为脊柱骨样骨瘤有效且安全的治疗方法。
