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椎体骨样骨瘤导致疼痛性脊柱侧凸

Osteoid Osteoma of the Body of the Vertebrae Causing Painful Scoliosis.

作者信息

Jain Mantu, Doki Sunil, Gantaguru Amrit, Mohakud Sudipta, Jha Shilpy

机构信息

Department of Orthopedics, AIIMS, Bhubaneswar, Odisha, India.

Department of Radiodiagnosis, AIIMS, Bhubaneswar, Odisha, India.

出版信息

Asian J Neurosurg. 2020 Oct 19;15(4):1037-1040. doi: 10.4103/ajns.AJNS_228_20. eCollection 2020 Oct-Dec.

Abstract

Osteoid osteoma (OO) affecting the spine is one of the common causes of painful scoliosis in the growing age group. The involvement is usually in the posterior elements involving the lumbar and cervical spine. We report a case of OO affecting the body of the thoracic vertebral body. A 15-year-old male presented with painful left thoracolumbar scoliosis. Computed tomography (CT) and magnetic resonance imaging (MRI) and MRI showed a lucent area with central dense focus (nidus) suggesting OO. Surgical excision was done under image intensifier and void filled with a mesh cage having bone graft reinforced posteriorly with pedicle screws. Postoperatively, the patient was relieved of his diffuse pain and CT scan revealed complete excision of the lesion. At the follow-up, the patient has an active, unconstrained life. OO in the spine presents as scoliosis which can be painful or painless. The diagnosis can be missed on a plain radiograph and complete radiographic evaluation includes a CT scan and MRI. Spinal management includes curettage or radiofrequency ablation. Recurrence is a known but rare complication.

摘要

骨样骨瘤(OO)累及脊柱是生长年龄段疼痛性脊柱侧凸的常见原因之一。受累通常发生在包括腰椎和颈椎的后部结构。我们报告一例骨样骨瘤累及胸椎椎体的病例。一名15岁男性因左侧胸腰段脊柱侧凸伴疼痛就诊。计算机断层扫描(CT)和磁共振成像(MRI)显示一个有中央致密灶(瘤巢)的透亮区,提示为骨样骨瘤。在影像增强器引导下进行手术切除,缺损处用带骨移植的网笼填充,并在后方用椎弓根螺钉加固。术后,患者的弥漫性疼痛缓解,CT扫描显示病变已完全切除。随访时,患者生活活跃,无受限情况。脊柱骨样骨瘤表现为脊柱侧凸,可为疼痛性或无痛性。普通X线片可能漏诊,完整的影像学评估包括CT扫描和MRI。脊柱的治疗方法包括刮除术或射频消融术。复发是一种已知但罕见的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4112/7869284/246c83726a0c/AJNS-15-1037-g001.jpg

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