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资源受限环境下有症状椎体血管瘤的管理

Management of symptomatic vertebral haemangioma in a resource challenged environment.

作者信息

Adeolu Augustine A, Balogun James A, Adeleye Amos O, Adeoye Peter O, Okolo Clement A, Ogbole Godwin I

机构信息

Department of Neurological Surgery, University College Hospital (UCH), Ibadan, Nigeria.

出版信息

Childs Nerv Syst. 2010 Jul;26(7):979-82. doi: 10.1007/s00381-010-1101-6. Epub 2010 Mar 10.

Abstract

INTRODUCTION

Vertebral haemangiomas are benign lesions and often asymptomatic. They are more common in the thoracic spine where they may become symptomatic with varying presentations.

CASE REPORTS

We present two teenage girls who presented with progressive, nontraumatic paraparesis with no background history of chronic cough or underlying medical illness.

DISCUSSION

The radiologic investigations were suggestive of vertebral haemangiomas of the thoracic spine. They had surgery: transthoracic approach with corpectomy and fusion with iliac crest autograft. The posterior stabilisation in the first patient was with Rush nails and circlage wire and only circlage wire in the second patient. The first patient's post-operative recovery was complicated by graft extrusion necessitating re-opening thoracotomy and graft replacement. They are, however, both ambulant at discharge and have remained so 13 and 15 months post-surgery.

CONCLUSION

We have presented two cases with rewarding outcomes in the face of 'adaptive' instrumentation due to limited resources.

摘要

引言

椎体血管瘤是良性病变,通常无症状。它们在胸椎更为常见,在胸椎处可能会出现各种不同表现的症状。

病例报告

我们介绍两名青少年女性,她们表现为进行性、非创伤性截瘫,无慢性咳嗽病史或潜在内科疾病。

讨论

影像学检查提示胸椎椎体血管瘤。她们接受了手术:经胸入路椎体切除并取自体髂嵴进行融合。第一例患者的后路固定使用了鲁什钉和环扎钢丝,第二例患者仅使用了环扎钢丝。第一例患者术后恢复因植骨块脱出而复杂化,需要再次开胸并更换植骨块。然而,她们在出院时均能行走,术后13个月和15个月仍保持如此。

结论

我们介绍了两例因资源有限而采用“适应性”器械治疗并取得良好结果的病例。

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