Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
Clin Orthop Relat Res. 2010 Jan;468(1):231-7. doi: 10.1007/s11999-009-0914-7. Epub 2009 Jun 4.
The optimal treatment of aneurysmal bone cysts remains an area of debate. Curettage, with or without adjuvant therapy, has been advocated for tumors in most locations. To evaluate argon beam coagulation as adjuvant therapy to curettage, we retrospectively analyzed the complication and recurrence rates in 40 consecutive patients with a diagnosis of aneurysmal bone cyst. For our analysis of recurrence, we excluded six of the 40 patients who were lost to followup or had less than 18 months followup; five patients treated with resection also were excluded. Of the remaining 29 patients, 17 were treated with curettage and argon beam coagulation and 12 were treated with curettage with or without phenol. None of the 17 patients treated with curettage and argon beam coagulation had a recurrence, whereas four patients treated without argon beam coagulation had recurrences. There were no differences between patients treated with or without argon beam coagulation regarding frequencies of intraoperative complications, neurovascular injury, or bone graft incorporation. Argon beam coagulation seems to offer favorable control rates when compared with curettage with or without phenol. No complications have been experienced thus far with its use.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
动脉瘤样骨囊肿的最佳治疗方法仍存在争议。刮除术,联合或不联合辅助治疗,已被推荐用于大多数部位的肿瘤。为了评估氩束凝固作为刮除术的辅助治疗,我们回顾性分析了 40 例诊断为动脉瘤样骨囊肿的连续患者的并发症和复发率。在我们的复发分析中,我们排除了 40 名失访或随访时间少于 18 个月的患者中的 6 名;也排除了 5 名接受切除术的患者。在剩余的 29 名患者中,17 名接受刮除术和氩束凝固治疗,12 名接受刮除术加或不加苯酚治疗。在接受刮除术和氩束凝固治疗的 17 名患者中,没有复发,而在未接受氩束凝固治疗的 4 名患者中,有 4 名复发。接受或不接受氩束凝固治疗的患者在术中并发症、神经血管损伤或骨移植融合的频率方面没有差异。与刮除术加或不加苯酚相比,氩束凝固似乎具有更好的控制率。到目前为止,其使用没有出现任何并发症。
IV 级,治疗研究。有关证据水平的完整描述,请参见作者指南。