活跃性单房性骨囊肿：首要控制，其次治愈。
Active unicameral bone cysts: control firstly, cure secondly.
机构信息
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, China.
Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
出版信息
J Orthop Surg Res. 2019 Aug 28;14(1):275. doi: 10.1186/s13018-019-1326-3.
PURPOSE
This retrospective study evaluated the efficacy of minimally invasive surgery to control cyst progression for active unicameral bone cysts (AUBC) by intracystic methylprednisolone injection, percutaneous curettage, and autogenous bone marrow grafting.
METHODS
From May 2010 to May 2017, patients diagnosed with AUBC who underwent percutaneous double-needle intracystic methylprednisolone injection, percutaneous curettage, and autogenous bone marrow grafting were retrospectively reviewed. Recurrence was defined by modified Neer scale score. Patients were followed up regularly, and previous imaging findings were compared to evaluate treatment efficacy.
RESULTS
The 26 patients (17 boys, 9 girls, mean age, 9.4 ± 3.1 years) were followed up for a mean 45.1 months (range, 24-82 months). Follow-up consisted of clinical evaluation and radiographic review. Twenty patients (77%) achieved latent disease stage after the first treatment, while six (23%) achieved it after the second treatment. Postoperative pathological fracture imaging scores were score I in 18 (70%), score II in five (19%), score III in two (8%), and score IV in one patient (4%). All 26 patients returned to their full activities and were asymptomatic at the most recent follow-up. The success rate (scores I and II) independent of the number of treatments was 89%. Treatment time was correlated with cyst size and length. Sex, age, cyst location and size, pathological fracture, and other clinical factors or radiological data did not influence the curative effect. No other complications occurred.
CONCLUSIONS
For AUBC, minimally invasive treatment is feasible to control cyst progression and then cure it without sequelae. Intracystic methylprednisolone injection, percutaneous curettage, and autogenous bone marrow grafting are an excellent choice.
目的
本回顾性研究通过囊内甲基泼尼松龙注射、经皮刮除和自体骨髓移植评估微创术控制活跃性单房性骨囊肿（AUBC）囊腔进展的疗效。
方法
2010 年 5 月至 2017 年 5 月，对接受经皮双针囊内甲基泼尼松龙注射、经皮刮除和自体骨髓移植的 AUBC 患者进行回顾性分析。采用改良 Neer 评分标准定义复发。定期对患者进行随访，并比较既往影像学发现以评估治疗效果。
结果
26 例患者（男 17 例，女 9 例，平均年龄 9.4±3.1 岁）获得平均 45.1 个月（24-82 个月）的随访。随访包括临床评估和影像学复查。20 例（77%）患者在首次治疗后达到潜伏疾病阶段，6 例（23%）患者在第二次治疗后达到潜伏疾病阶段。术后病理性骨折影像学评分 18 例（70%）为 I 型，5 例（19%）为 II 型，2 例（8%）为 III 型，1 例（4%）为 IV 型。26 例患者均恢复至完全活动状态，末次随访时均无症状。无论治疗次数如何，成功率（评分 I 和 II）为 89%。治疗时间与囊肿大小和长度相关。性别、年龄、囊肿位置和大小、病理性骨折及其他临床因素或影像学资料均不影响疗效。无其他并发症发生。
结论
对于 AUBC，微创治疗可控制囊腔进展并治愈疾病，且无后遗症。囊内甲基泼尼松龙注射、经皮刮除和自体骨髓移植是一种很好的选择。
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