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腰骶部固定术辅助下的部分骶骨切除术治疗骶骨巨细胞瘤：强调最佳神经肿瘤学结局

Partial Sacrectomy With Lumbopelvic Fixation for Sacral Giant Cell Tumor: Emphasizing Optimal Neuro-Oncological Outcomes.

作者信息

Gotecha Sarang, Chugh Ashish, Punia Prashant, Aziz Ramis, Gaud Jayant, Rege Ishant

机构信息

Neurosurgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Oct 16;16(10):e71602. doi: 10.7759/cureus.71602. eCollection 2024 Oct.

DOI:10.7759/cureus.71602
PMID:39552987
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11566391/
Abstract

Giant cell tumors (GCTs) of bone are classified as intermediate malignant tumors with a significant potential for local infiltration. Despite their benign histopathological appearance, these tumors exhibit extreme local aggression. The sacrum is the most commonly affected spinal region, followed by the lumbar, cervical, and thoracic regions. Active treatment of sacral GCTs is essential for preserving the sacral nerve roots and filum, allowing patients to maintain an impairment-free life. While excision of sacral GCTs enhances local control, it poses challenges, including the risk of losing bowel and bladder control. In this report, the authors share their experience with lumbopelvic fixation using gluteus maximus flaps to address the dead space following partial sacrectomy for sacral GCT in a 35-year-old female, ultimately achieving an optimal neuro-oncological outcome.

摘要

骨巨细胞瘤（GCTs）被归类为具有显著局部浸润潜力的中间性恶性肿瘤。尽管其组织病理学表现为良性，但这些肿瘤具有极强的局部侵袭性。骶骨是脊柱最常受累的部位，其次是腰椎、颈椎和胸椎区域。积极治疗骶骨GCTs对于保留骶神经根和终丝至关重要，可使患者维持无功能障碍的生活。虽然骶骨GCTs的切除可增强局部控制，但也带来了挑战，包括失去肠道和膀胱控制的风险。在本报告中，作者分享了他们对一名35岁女性骶骨GCT行部分骶骨切除术后，使用臀大肌瓣进行腰骶部固定以解决死腔问题的经验，最终实现了最佳的神经肿瘤学结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/5e3ae7b84cf1/cureus-0016-00000071602-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/0fff1030ee5f/cureus-0016-00000071602-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/fe5ad9d8918e/cureus-0016-00000071602-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/31b5b975fd29/cureus-0016-00000071602-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/c5341ee2a807/cureus-0016-00000071602-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/395b8eaebc7e/cureus-0016-00000071602-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/94be33125288/cureus-0016-00000071602-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/5e3ae7b84cf1/cureus-0016-00000071602-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/0fff1030ee5f/cureus-0016-00000071602-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/fe5ad9d8918e/cureus-0016-00000071602-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/31b5b975fd29/cureus-0016-00000071602-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/c5341ee2a807/cureus-0016-00000071602-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/395b8eaebc7e/cureus-0016-00000071602-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/94be33125288/cureus-0016-00000071602-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ae/11566391/5e3ae7b84cf1/cureus-0016-00000071602-i07.jpg

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本文引用的文献

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Clinical manifestations, classification, and surgical management of sacral tumors and the need for personalized approach to sacrectomy.骶骨肿瘤的临床表现、分类及手术治疗，以及骶骨切除术个性化方法的必要性。
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