Song Yu, Geng Wen, Guo Tao, Gao Yong, Zhang Yukun, Li Shuai, Wang Kun, Tu Ji, Yang Cao
Department of Orthopedics, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Medicine (Baltimore). 2017 Jun;96(25):e7197. doi: 10.1097/MD.0000000000007197.
Solitary eosinophilic granuloma (EG), the most benign, common form of Langerhans cell histiocytosis, has a self-limiting process and is associated with a good prognosis. Immobilization is recommended as the first treatment strategy for solitary EG, although the treatment protocols are still controversial. Radiotherapy and surgery are secondary treatment choices. Lesions of the upper cervical spine react differently to treatment because of their specific anatomical and motor features.
We discuss the case of a 29-year-old man with axis EG who underwent immobilization, radiotherapy, and finally surgery.
Eosinophilic granuloma (EG).
An initial conservative protocol, including immobilization with a collar and radiotherapy, effectively relieved his neck pain, whereas torticollis secondary to atlantoaxial subluxation was not improved. Therefore, he underwent tumor resection through the anterior approach and spinal reconstruction, fixation, and fusion through the posterior approach.
The deformity was well corrected and follow-up was satisfactory.
Upon review of the literature, we found that EG lesions affecting the axis have more risk factors for instability or deformity, and they have particular anatomical and motor characteristics; thus, they require more consideration and attention in terms of treatment, prognosis, and follow-up.
孤立性嗜酸性肉芽肿（EG）是朗格汉斯细胞组织细胞增多症最良性、最常见的形式，具有自限性过程，预后良好。尽管治疗方案仍存在争议，但固定被推荐为孤立性EG的首选治疗策略。放疗和手术是二线治疗选择。由于上颈椎病变具有特殊的解剖和运动特征，其对治疗的反应有所不同。
我们讨论了一名29岁的枢椎EG男性患者的病例，该患者接受了固定、放疗，最终接受了手术。
嗜酸性肉芽肿（EG）。
最初的保守方案，包括使用颈托固定和放疗，有效缓解了他的颈部疼痛，但寰枢椎半脱位继发的斜颈并未改善。因此，他接受了前路肿瘤切除以及后路脊柱重建、固定和融合手术。
畸形得到良好矫正，随访结果令人满意。
通过文献回顾，我们发现影响枢椎的EG病变具有更多不稳定或畸形的危险因素，且具有特殊的解剖和运动特征；因此，在治疗、预后和随访方面需要更多的考虑和关注。
