Zileli Mehmet, Cagli Sedat, Basdemir Gülcin, Ersahin Yusuf
Department of Neurosurgery, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
Neurosurg Focus. 2003 Nov 15;15(5):E5.
OBJECT: Osteoid osteomas and osteoblastomas are rare primary bone tumors that usually do not arise in the spine. In this report the authors analyze 16 cases of osteoid osteoma or osteoblastoma of the spine that were surgically treated over a 27-year period. METHODS: A retrospective study was conducted in which the following data were found: five patients had osteoid osteomas (two male and three female patients) and 11 had osteoblastomas (seven male and four female patients). The site of the tumor was the cervical spine in four, thoracic in six, and lumbar spine in six. In 14 patients, the tumor involved the posterior vertebral elements, with lumbar and thoracic levels being the most common. Only two patients had tumors in the body of a cervical vertebra. The mean age of the patients was 20 years for osteoid osteoma and 19 years for osteoblastoma. The most common symptom was local pain in the area of the tumor. Among 11 patients with osteoblastoma, six (two with paraparesis, four with monoparesis) had neurological deficits caused by extradural compression. None of the patients with osteoid osteoma had neurological deficits. The diameters of osteoblastomas were 3 to 8 cm (mean 4 cm), and those of osteoid osteomas were 1.5 to 2 cm (mean 1.7 cm). Although the peritumoral bone was normal in patients with osteoblastoma, a sclerotic rim was observed in all patients with osteoid osteoma. All patients were treated with resection; tumor excision was complete in 15 cases. Follow-up periods ranged from 2 months to 13 years (mean 36 months). Complete pain relief was achieved in 15 patients; the other patient described mild pain with activity. There was no tumor recurrence except one regrowth in a patient with osteoblastoma who then received radiation therapy. There were two complications: one surgery was performed at the wrong level, and there was one instrument failure that required revision. CONCLUSIONS: With the help of modern imaging modalities that aid in diagnosis and surgical planning, a complete removal and cure may be achieved for most of these rare tumors.
目的：骨样骨瘤和成骨细胞瘤是罕见的原发性骨肿瘤，通常不在脊柱发生。在本报告中，作者分析了27年间经手术治疗的16例脊柱骨样骨瘤或成骨细胞瘤病例。 方法：进行一项回顾性研究，发现以下数据：5例为骨样骨瘤（2例男性和3例女性患者），11例为成骨细胞瘤（7例男性和4例女性患者）。肿瘤部位为颈椎4例、胸椎6例、腰椎6例。14例患者肿瘤累及椎体后部结构，以腰椎和胸椎节段最为常见。仅2例患者肿瘤位于颈椎椎体。骨样骨瘤患者的平均年龄为20岁，成骨细胞瘤患者为19岁。最常见的症状是肿瘤部位局部疼痛。在11例成骨细胞瘤患者中，6例（2例双下肢轻瘫、4例单下肢轻瘫）因硬膜外压迫出现神经功能缺损。骨样骨瘤患者均无神经功能缺损。成骨细胞瘤直径为3至8 cm（平均4 cm），骨样骨瘤直径为1.5至2 cm（平均1.7 cm）。虽然成骨细胞瘤患者的瘤周骨正常，但所有骨样骨瘤患者均观察到硬化边缘。所有患者均接受手术切除；15例患者肿瘤切除彻底。随访时间为2个月至13年（平均36个月）。15例患者疼痛完全缓解；另1例患者活动时诉轻度疼痛。除1例成骨细胞瘤患者肿瘤复发后接受放疗外，无肿瘤复发。有2例并发症：1例手术节段错误，1例内固定失败需要翻修。 结论：借助有助于诊断和手术规划的现代影像学手段，大多数此类罕见肿瘤可实现完整切除并治愈。
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