Laus M, Albisinni U, Alfonso C, Zappoli F A
Orthopaedics e Traumatology, Department for Special Surgery and Anesthesiology, S. Orsola-Malpighi Hospital, Via Albertoni, 15, 40138, Bologna, Italy.
Eur Spine J. 2007 Dec;16(12):2078-82. doi: 10.1007/s00586-007-0478-8. Epub 2007 Sep 14.
Osteoid osteoma (OO) of the cervical spine is frequently located close to the vertebral artery, spinal cord, or nerve roots and complete surgical excision is sometimes difficult by a limited approach and more extended surgery can require spinal fusion. Percutaneous radiofrequency coagulation (PRC) has demonstrated efficacy in the treatment of OO of the pelvis and limbs however, its role in the cervical spine is still nuclear. The Authors present a series of nine cases of OO of the cervical spine, six treated with surgical excision and three with PRC. No neurological or vascular complications occurred in both series. One case of the surgical series had only partial relief of persistent pain for 1 year due to incomplete excision, but is doing well 4 years after surgery. All the other surgical cases had complete relief of symptoms immediately after surgery and are symptom-free 3-10 years later. Two cases of PRC had complete relief of symptoms 24-48 h after surgery and are symptom-free 2 and 3 years later. One case of recurrent OO after surgery and treated with PRC with a reduced dose improved only, and still requires anti-inflammatory drugs 2 years after the procedure. Our still limited experience suggests that PRC can be safely performed in local anaesthesia with the patient awake, enabling to check for signs and symptoms of possible neurological injury. PRC can substitute extensive posterior approaches and reconstructions for OO of the posterior arch and joint pillar.
颈椎骨样骨瘤（OO）常位于椎动脉、脊髓或神经根附近，有时通过有限的手术入路难以完整切除，而更广泛的手术可能需要脊柱融合。经皮射频消融（PRC）已证明对骨盆和四肢的骨样骨瘤治疗有效，然而其在颈椎的作用仍不明确。作者报告了一系列9例颈椎骨样骨瘤病例，其中6例接受手术切除，3例接受PRC治疗。两个系列均未发生神经或血管并发症。手术系列中有1例因切除不完全，术后持续疼痛仅部分缓解1年，但术后4年情况良好。所有其他手术病例术后症状立即完全缓解，3 - 10年后无症状。2例PRC治疗的病例术后24 - 48小时症状完全缓解，2年和3年后无症状。1例术后复发的骨样骨瘤经PRC治疗，剂量减少后仅有所改善，术后2年仍需使用抗炎药物。我们目前有限的经验表明，PRC可在患者清醒的局部麻醉下安全进行，以便检查可能的神经损伤体征和症状。PRC可替代后弓和关节突骨样骨瘤的广泛后入路和重建手术。
