Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
J Am Acad Orthop Surg. 2012 Oct;20(10):646-56. doi: 10.5435/JAAOS-20-10-646.
In the pediatric population, malignant osseous tumors of the spine include osteosarcoma, Ewing sarcoma, lymphoma, and metastatic neuroblastoma. Although these tumors are rare, prompt diagnosis and recognition are critical to the overall prognosis. Improved understanding of the natural history of spine deformity, combined with advances in imaging, surgical technology, radiation therapy, and chemotherapeutic regimens, has improved survival rates and decreased rates of local recurrence-especially recurrence of low-grade lesions. Prognosis for patients with high-grade lesions with distant metastasis on presentation remains exceedingly poor. Recognition of these spine tumors and prompt referral to a tertiary care center that specializes in oncology can optimize patient outcomes.
在儿科人群中，脊柱的恶性骨肿瘤包括骨肉瘤、尤文肉瘤、淋巴瘤和转移性神经母细胞瘤。尽管这些肿瘤很少见，但及时诊断和识别对于整体预后至关重要。对脊柱畸形自然史的深入了解，加上影像学、手术技术、放射治疗和化疗方案的进步，提高了生存率，降低了局部复发率——尤其是低度病变的复发率。对于初诊时就有远处转移的高级别病变患者，预后仍然极差。认识到这些脊柱肿瘤并及时转至专门从事肿瘤学的三级治疗中心可以优化患者的治疗效果。
