Boude Adriana Bruges, Vásquez Lina González, Alvarado-Gomez Fernando, Bedoya María Constanza, Rodríguez-Múnera Andrés, Morales-Saenz Luis Carlos
Department of Orthopedic Surgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia.
Case Rep Orthop. 2017;2017:8908216. doi: 10.1155/2017/8908216. Epub 2017 May 28.
Spinal simple bone cysts, also known as solitary cysts, are extremely unusual benign primary bone tumors with few cases reported in the literature.
Incidental Magnetic Resonance Imaging (MRI) finding of a C2 Simple bone cyst in a 13-year-old female patient is reported. Complementary studies suggested the benign nature of the lesion. Patient underwent cervical curettage followed by tumor excision. A lateral submandibular approach to the upper cervical spine was used and careful bone resection was possible with a radiofrequency assisted burr and no instrumentation or fixation was required. The stability of the defect was ensured by filling it with bone allograft and by prescribing a postsurgical plastic cervical collar to maintain neck immobilization. Histological examination supported the diagnosis of simple bone cyst. At 6-12-month follow-up the patient presented no recurrence or symptomatology.
Solitary bone cysts are infrequent entities in the cervical vertebrae and preservation of spine stability without instrumentation to avoid neurological complications is often challenging. In this case, the proximity of the cyst to the right vertebral artery and the risk of injury were high; however the surgical approach used was successful and no recurrence or instability was evidenced on postoperative MRI.
脊柱单纯性骨囊肿,也称为孤立性囊肿,是极其罕见的良性原发性骨肿瘤,文献报道的病例很少。
本文报告了一名13岁女性患者,通过偶然的磁共振成像(MRI)发现C2椎体存在单纯性骨囊肿。补充检查提示该病变为良性。患者接受了颈椎刮除术及肿瘤切除术。采用下颌下外侧入路处理上颈椎,使用射频辅助磨钻仔细切除骨质,无需器械固定。通过植入同种异体骨并佩戴术后塑形颈托保持颈部固定,确保了缺损部位的稳定性。组织学检查支持单纯性骨囊肿的诊断。在6至12个月的随访中,患者未出现复发或症状。
孤立性骨囊肿在颈椎中较为少见,在不使用器械的情况下保留脊柱稳定性以避免神经并发症往往具有挑战性。在本病例中,囊肿靠近右侧椎动脉,损伤风险较高;然而,所采用的手术方法是成功的,术后MRI未显示复发或不稳定情况。