Lange Nicole, Jörger Ann-Kathrin, Ryang Yu-Mi, Liesche-Starnecker Friederike, Gempt Jens, Meyer Bernhard
Department of Neurosurgery, Klinikum Rechts der Isar, Technical University, 81675 Munich, Germany.
Department of Neurosurgery, Helios Klinikum Berlin-Buch, 13125 Berlin, Germany.
Diagnostics (Basel). 2022 Sep 19;12(9):2264. doi: 10.3390/diagnostics12092264.
This study reports a large single-center series of primary bone tumors of the spine (PBTs). We aimed to review the concepts for management, as this kind of tumor represents a very rare entity, and also propose a new treatment algorithm. Retrospective analysis revealed 92 patients receiving surgery for PBTs from 2007 to 2019 at our center. They were analyzed based on surgical management and the course of the disease. A total of 145 surgical procedures were performed (50 cervical, 46 thoracic, 28 lumbar, and 21 sacral). Complete tumor resection was achieved in 65%, of which 22% showed tumor recurrence during follow-up (mean time to recurrence 334 days). The five-year mortality rate was significantly lower after complete resection (3% versus 25% after subtotal resection). Most of the patients improved in their symptoms through surgery. Regarding the tumor entity, the most common PBTs were vertebral hemangiomas (20%), osteoid osteomas (15%), and chordomas (16%). The Enneking graduation system showed a good correlation with the risk of recurrence and mortality. Complete resection in PBTs increased survival rates and remains the method of choice. Thus, quality of life-especially with a higher extent of resection-should be considered.
本研究报告了一组来自单中心的大量脊柱原发性骨肿瘤（PBTs）病例。由于这类肿瘤非常罕见，我们旨在回顾其治疗理念，并提出一种新的治疗算法。回顾性分析显示，2007年至2019年期间，我们中心有92例患者接受了PBTs手术。根据手术治疗和疾病进程对他们进行了分析。共进行了145例手术（颈椎50例、胸椎46例、腰椎28例、骶椎21例）。65%的患者实现了肿瘤完全切除，其中22%在随访期间出现肿瘤复发（平均复发时间334天）。完全切除后的五年死亡率显著低于次全切除（分别为3%和25%）。大多数患者通过手术症状得到改善。就肿瘤类型而言，最常见的PBTs是椎体血管瘤（20%）、骨样骨瘤（15%）和弦瘤（16%）。Enneking分级系统与复发和死亡风险显示出良好的相关性。PBTs的完全切除提高了生存率，仍然是首选方法。因此，应考虑生活质量，尤其是在切除范围较大的情况下。
