Sen Harun Emre, Bayrak Busra Yaprak, Etus Volkan
Department of Neurosurgery, Kocaeli University, School of Medicine, Kocaeli, Turkey.
Department of Pathology, Kocaeli University, School of Medicine, Kocaeli, Turkey.
Surg Neurol Int. 2024 Jan 19;15:20. doi: 10.25259/SNI_854_2023. eCollection 2024.
Osteoblastomas, although rare, are benign primary bone tumors, with cervical spine involvement being exceptionally uncommon. Late diagnosis, especially in aggressive cases, can lead to surgical challenges. Oxidized regenerated cellulose (ORC) used for hemostasis may result in complications if left in the surgical field.
An 8-year-old female presented with six months of intractable neck pain accompanied by swelling, hindering proximal right upper extremity evaluation. Motor strength was intact distally, with normal reflexes and no hypoesthesia. Imaging revealed a C4-5 facet joint lesion necessitating surgery. Intraoperative hemorrhage prompted ORC application, which led to postoperative arm pain and C5-6 radiculopathy. Subsequent surgery alleviated these symptoms.
Osteoblastomas, despite their benign classification, may exhibit aggressive characteristics, warranting resection. Cervical spine osteoblastomas, due to their vascular nature and proximity to vital structures, complicate surgical interventions. ORC, a commonly used hemostatic agent, may induce compression complications, and early intervention is critical for patient recovery. This case underscores the intricacies of managing aggressive osteoblastomas in the cervical spine and highlights potential ORC-related complications. Surgeons must exercise caution when using ORC and consider postoperative risks. Prompt intervention and meticulous planning are paramount for favorable outcomes in such cases.
成骨细胞瘤虽然罕见，但为原发性良性骨肿瘤，累及颈椎者尤为少见。诊断延迟，尤其是侵袭性病例，可导致手术挑战。用于止血的氧化再生纤维素（ORC）若留在手术区域可能导致并发症。
一名8岁女性出现6个月的顽固性颈部疼痛并伴有肿胀，妨碍了对右上臂近端的评估。远端肌力完好，反射正常，无感觉减退。影像学检查显示C4-5小关节病变，需要手术治疗。术中出血促使使用ORC，导致术后手臂疼痛和C5-6神经根病。后续手术缓解了这些症状。
成骨细胞瘤尽管归类为良性，但可能具有侵袭性特征，需要切除。颈椎成骨细胞瘤因其血管性质和靠近重要结构，使手术干预变得复杂。ORC是一种常用的止血剂，可能引发压迫并发症，早期干预对患者康复至关重要。本病例强调了颈椎侵袭性成骨细胞瘤管理的复杂性，并突出了与ORC相关的潜在并发症。外科医生在使用ORC时必须谨慎，并考虑术后风险。对于此类病例，及时干预和精心规划对于取得良好结果至关重要。
