Erdogan Koral, Solmaz Serdar, Dogan Ihsan
Department of Neurosurgery, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey.
J Craniovertebr Junction Spine. 2021 Jul-Sep;12(3):236-239. doi: 10.4103/jcvjs.jcvjs_142_20. Epub 2021 Sep 8.
Langerhans cell histiocytosis (LCH) is a rare nonmalignant disease characterized by a clonal proliferation of mononuclear cells called Langerhans histiocytes and infiltrates surrounding tissues, mostly self-limiting and usually occurring in the first two decades of life. Vertebral involvement is rare, mostly seen in the thoracic region, and involves the anterior elements of the corpus. In the literature, several treatment options and surgical approaches have been reported concerning the treatment of this disease and surgery.
We report an 18-month-old male with thoracic LCH who underwent surgery due to progressive neurological deficit. Gross total removal of the tumor with one level corpectomy in this patient was achieved via a posterolateral approach with postoperative functional improvement. The surgical cavity was supported by corpectomy cage and unilateral screw-rod fixation system at the same stage.
Gross total tumor removal, corpectomy, and 360° stabilization via posterolateral approach at a single stage are safe, effective, and definite neurosurgical methods in terms of providing neurological recovery, long-term tumor-free survival, and spinal stability.
朗格汉斯细胞组织细胞增多症（LCH）是一种罕见的非恶性疾病，其特征为名为朗格汉斯组织细胞的单核细胞克隆性增殖并浸润周围组织，大多为自限性，通常发生在生命的前二十年。脊柱受累罕见，多见于胸椎区域，累及椎体前部结构。在文献中，已报道了关于该疾病治疗及手术的多种治疗选择和手术方法。
我们报告一名18个月大患有胸椎LCH的男性患者，因进行性神经功能缺损而接受手术。通过后外侧入路实现了该患者肿瘤的全切除及一个节段的椎体切除，术后功能得到改善。手术腔在同一阶段通过椎体切除椎间融合器和单侧螺钉-棒固定系统进行支撑。
就实现神经功能恢复、长期无瘤生存及脊柱稳定性而言，经后外侧入路一期行肿瘤全切除、椎体切除及360°固定是安全、有效且确切的神经外科手术方法。
