Argyriou Andreas A, Panagiotopoulos Vasileios, Masmanidis Aristeidis, Tzortzidis Fotios, Konstantinou Dimitrios
Department of Neurology, Saint Andrew's General Hospital of Patras, Patras, Greece.
J Emerg Med. 2013 Jan;44(1):e1-4. doi: 10.1016/j.jemermed.2011.05.089. Epub 2011 Dec 22.
Osteoblastomas are rare benign bone tumors that are mostly found in the posterior spinal elements; about 20% are located in the cervical spine.
The case of a destructive cervical osteoblastoma at C5 is reported in a 19-year-old man who initially presented with spastic quadriparesis.
A 19-year-old man was self-referred, reporting symptoms in keeping with a progressive spastic quadriparesis, which had suddenly developed 6 days earlier. Preceding symptoms included mild non-specific neck pain for 3 weeks. The patient was afebrile, and no ambulatory X-ray study had been performed until the time of referral. A cervical spine computed tomography (CT) scan revealed a lytic lesion involving the spinal process and the pedicles of the C5 vertebra. Cervical spine magnetic resonance imaging performed on an inpatient basis revealed a well-circumscribed, destructive lesion of the C5 vertebra, measuring approximately 3 cm. The spinal cord was significantly compressed. The patient underwent open surgical resection of the tumor through a midline posterior approach. Histopathology of the tumor specimen was in keeping with a diagnosis of osteoblastoma.
Neuroimaging should be performed with either conventional plain X-ray study, which seems to be sufficient in patients presenting with non-specific symptomatology related to cervical spine damage, or with advanced techniques in the case of patients with persistent neck pain or neurological deficit.
骨母细胞瘤是一种罕见的良性骨肿瘤，大多位于脊柱后部结构；约20%位于颈椎。
报告一例19岁男性C5椎体侵袭性颈椎骨母细胞瘤病例，该患者最初表现为痉挛性四肢瘫。
一名19岁男性自行前来就诊，自述症状符合进行性痉挛性四肢瘫，此症状于6天前突然出现。之前的症状包括3周的轻度非特异性颈部疼痛。患者无发热，转诊时未进行门诊X线检查。颈椎计算机断层扫描（CT）显示C5椎体棘突和椎弓根有溶骨性病变。住院期间进行的颈椎磁共振成像显示C5椎体有一个边界清晰的侵袭性病变，大小约3厘米。脊髓明显受压。患者通过后正中入路接受了肿瘤开放手术切除。肿瘤标本的组织病理学检查结果符合骨母细胞瘤的诊断。
对于出现与颈椎损伤相关的非特异性症状的患者，可采用传统的普通X线检查进行神经影像学检查，这似乎就足够了；对于持续颈部疼痛或神经功能缺损的患者，则应采用先进技术进行检查。
