Tanaka Masato, Sugimoto Yoshihisa, Takigawa Tomoyuki, Kimata Yoshihiro, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558,
Acta Med Okayama. 2017 Aug;71(4):345-349. doi: 10.18926/AMO/55312.
Osteoradionecrosis (ORN), a well-known complication of radiotherapy in the mandibular bone, is very rare in the cervical spine. The authors report the result of a 3-year follow-up of a 63-year-old female patient with ORN of the cervical spine. The patient had a history of laryngeal carcinoma and was treated with chemotherapy and radiation therapy with a total of 120 Gy. Eight years later, she developed acute, severe neck pain due to cervical spine necrosis. The authors performed vascularized fibular bone graft and posterior pedicle screw fixation to reconstruct her cervical spine. The patient was successfully treated with surgery, and cervical alignment was preserved. She had neither neurological deficits nor severe neck pain at her final follow-up 3 years later. Delaying treatment of ORN may be life threatening, so the early diagnosis of this condition is important for patients who receive radiotherapy. Otolaryngologists and spine surgeons should understand this potential complication to speed diagnosis and treatment as early as possible.
放射性骨坏死（ORN）是下颌骨放疗的一种常见并发症，在颈椎中极为罕见。作者报告了一名63岁颈椎ORN女性患者的3年随访结果。该患者有喉癌病史，接受了总计120 Gy的化疗和放疗。八年后，她因颈椎坏死出现急性、严重的颈部疼痛。作者进行了带血管腓骨移植和后路椎弓根螺钉固定以重建她的颈椎。患者通过手术成功治疗，颈椎排列得以保留。3年后最后一次随访时，她既没有神经功能缺损，也没有严重的颈部疼痛。延迟ORN的治疗可能危及生命，因此对于接受放疗的患者，这种情况的早期诊断很重要。耳鼻喉科医生和脊柱外科医生应了解这种潜在并发症，以便尽早加快诊断和治疗。
