Wang Lin-Nan, Hu Bo-Wen, Wang Lei, Yang Xi, Liu Li-Min, Song Yue-Ming
Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041, China.
BMC Musculoskelet Disord. 2017 Dec 19;18(1):538. doi: 10.1186/s12891-017-1902-9.
Osteoblastoma is a rare and benign tumor which requires early diagnosis and surgical excision. Scoliosis is a common presentation following osteoblastoma. It is considered due to pain-provoked muscle spasm on the side of the lesion. Few researches about osteoblastoma combined with severe scoliosis have been reported.
A 14-year-old girl presents with progressive scoliosis deformity for 3 years, with gradually appeared low back pain and numbness of left leg. Radiographic results showed osteoblastic mass at the left side of L3-L4 with severe scoliosis deformity, pelvic obliquity and spinal imbalance. The patient underwent posterior tumor excision, spinal decompression, scoliosis correction, spinal fusion with auto-graft and instrumentation from T8-S1. The mass was found to be osteoblastoma. The patient had a full neurological recovery with no aggravate of scoliosis or spinal imbalance during the follow-up.
This case emphasizes the importance of early diagnosis and surgical treatment of osteoblastoma. Early surgical excision will not only prevent neurological deficit but also the progression of scoliosis. Atypical scoliosis presence without pain requires carefully examination of whether a tumor exists.
骨母细胞瘤是一种罕见的良性肿瘤,需要早期诊断和手术切除。脊柱侧弯是骨母细胞瘤后的常见表现。这被认为是由于病变侧疼痛引起的肌肉痉挛所致。关于骨母细胞瘤合并严重脊柱侧弯的研究报道较少。
一名14岁女孩出现进行性脊柱侧弯畸形3年,逐渐出现下腰痛和左腿麻木。影像学结果显示L3-L4左侧有成骨细胞瘤块,伴有严重的脊柱侧弯畸形、骨盆倾斜和脊柱失衡。患者接受了后路肿瘤切除、脊柱减压、脊柱侧弯矫正、自体骨移植和T8-S1内固定融合术。肿块被发现是骨母细胞瘤。患者神经功能完全恢复,随访期间脊柱侧弯或脊柱失衡未加重。
该病例强调了骨母细胞瘤早期诊断和手术治疗的重要性。早期手术切除不仅可以预防神经功能缺损,还可以防止脊柱侧弯的进展。无疼痛的非典型脊柱侧弯需要仔细检查是否存在肿瘤。