Department of Orthopaedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
Department of Radiology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
Eur Spine J. 2019 Jun;28(6):1529-1536. doi: 10.1007/s00586-018-5836-1. Epub 2018 Nov 23.
This study aimed to validate the safety and effectiveness of percutaneous doxycycline/albumin injection for spinal aneurysmal bone cysts (ABCs) as an alternative to open surgery.
From January 2000 to December 2016, 25 patients who had no/minor neurological deficits (modified Frankel scale D or E) and acceptable local stability (spinal instability neoplastic score < 12) were included in the study, of whom 14 were treated with percutaneous doxycycline/albumin injection (injection group) and 11 were treated with open surgery (surgery group). The demographic and clinical information of the injection and surgery groups were recorded and compared.
In the injection group, lesion size was significantly reduced in all 14 patients, all patients showed complete neurological recovery, and 13 patients had complete relief of neck pain; their mean visual analogue scale (VAS) decreased from 3.4 to 0.5. No complication or recurrence was observed during the mean 30.7-month follow-up (range, 24-50 months). In the surgery group, 9 patients had complete neurological recovery and 2 patients had residual slight paresthesia; their mean VAS decreased from 3.4 to 0.5. Two had local recurrence during their follow-up at 66.5 months (range, 50-96 months). Compared with the surgery group, the injection group showed no significant difference in the rate of recurrence (P = 0.14) and complication (P = 0.36).
Percutaneous doxycycline/albumin injection for spinal ABCs can be safely and effectively performed in well-selected cases. It could serve as an alternative treatment, especially for spinal ABCs lesions with acceptable local stability and in patients without severe neurological deficits. These slides can be retrieved under Electronic Supplementary Material.
本研究旨在验证经皮多西环素/白蛋白注射治疗脊柱动脉瘤样骨囊肿（ABC）的安全性和有效性，作为开放手术的替代方法。
2000 年 1 月至 2016 年 12 月，共纳入 25 例无/轻度神经功能缺损（改良 Frankel 分级 D 或 E）和可接受局部稳定性（脊柱不稳肿瘤评分＜12）的患者，其中 14 例接受经皮多西环素/白蛋白注射治疗（注射组），11 例接受开放手术治疗（手术组）。记录并比较两组患者的人口统计学和临床资料。
在注射组，14 例患者的病变大小均显著缩小，所有患者均完全恢复神经功能，13 例患者完全缓解颈部疼痛，平均视觉模拟评分（VAS）从 3.4 分降至 0.5 分。在平均 30.7 个月的随访期间（范围，24-50 个月），未观察到任何并发症或复发。在手术组，9 例患者完全恢复神经功能，2 例患者仍有轻微感觉异常，平均 VAS 从 3.4 分降至 0.5 分。2 例患者在 66.5 个月（范围，50-96 个月）的随访期间局部复发。与手术组相比，注射组的复发率（P=0.14）和并发症发生率（P=0.36）差异无统计学意义。
对于选择合适的病例，经皮多西环素/白蛋白注射治疗脊柱 ABC 是安全有效的，可以作为一种替代治疗方法，尤其适用于局部稳定性可接受且无严重神经功能缺损的脊柱 ABC 病变患者。这些幻灯片可以在电子补充材料中检索到。
