Beiner John M, Sastry Akhilesh, Berchuck Matthew, Grauer Jonathan N, Kwon Brian K, Ratliff John K, Stock Gordon H, Brown Andrew K, Vaccaro Alexander R
Connecticut Orthopaedic Specialists and Department of Orthopaedics, Yale University School of Medicine, New Haven, CT, USA.
Spine (Phila Pa 1976). 2006 Jun 15;31(14):E475-9. doi: 10.1097/01.brs.0000222126.91514.cb.
An aneurysmal bone cyst in the neural arch of the fourth cervical vertebra of a 10-year-old girl is reported, along with a brief review of the literature on the topic.
To report the presentation and diagnosis of this disorder along with a discussion of the major pitfalls of treatment.
An aneurysmal bone cyst occurs commonly in the second decade, with a predilection for the lumbar spine. With occurrence in the neural arch of a cervical vertebra, the potential for instability following surgical excision is high.
A 10-year-old white female presented with neck pain of 3 months' duration. Diagnostic imaging revealed an expansile lytic lesion in the spinous process and lamina of the fourth cervical vertebra. Surgical treatment consisted of excisional biopsy and a segmental instrumented posterior fusion from C3-C5. The histopathology was consistent with an aneurysmal bone cyst.
Surgical excision consisting of laminectomy and instrumented segmental fusion provided a good clinical result, and minimized the risk and degree of the 2 most common complications: recurrence of the tumor; and postlaminectomy kyphosis, a frequent occurrence in the pediatric population.
In pediatric patients who develop a bone tumor of the posterior elements of the cervical spine, careful clinical and radiologic evaluation is necessary to narrow the differential diagnosis. In most cases, a complete excision should be performed if possible. The risk of postlaminectomy kyphosis is high in the pediatric age population. As such, a fusion should be considered whenever a laminectomy is performed in the immature cervical spine. Risk factors for kyphosis include a high cervical level, multiple laminectomy levels, and postoperative irradiation.
报告一名10岁女孩第四颈椎神经弓的动脉瘤样骨囊肿病例，并对该主题的文献进行简要综述。
报告该疾病的表现和诊断，并讨论治疗的主要陷阱。
动脉瘤样骨囊肿常见于第二个十年，好发于腰椎。发生在颈椎神经弓时，手术切除后发生不稳定的可能性很高。
一名10岁白人女性出现持续3个月的颈部疼痛。诊断性影像学检查显示第四颈椎棘突和椎板有膨胀性溶骨性病变。手术治疗包括切除活检和C3 - C5节段的后路器械辅助融合术。组织病理学结果与动脉瘤样骨囊肿一致。
包括椎板切除术和器械辅助节段融合术的手术切除取得了良好的临床效果，并将两种最常见并发症的风险和程度降至最低：肿瘤复发；以及椎板切除术后脊柱后凸，这在儿童人群中很常见。
对于发生颈椎后部骨肿瘤的儿科患者，需要进行仔细的临床和影像学评估以缩小鉴别诊断范围。在大多数情况下，应尽可能进行完整切除。椎板切除术后脊柱后凸在儿童年龄组中的风险很高。因此，在未成熟颈椎进行椎板切除术时应考虑融合术。脊柱后凸的危险因素包括颈椎高位、多个椎板切除节段和术后放疗。
