Xu Jianglong, Zou Yan, Zhang Hanwen, Chen Jinchen, Liu Haonan, Guo Dong, Yao Ziming
Department of Orthopaedics, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Department of Orthopaedics, Hebei Children's Hospital, Shijiazhuang, China.
J Child Orthop. 2024 Dec 1;18(6):632-641. doi: 10.1177/18632521241287031. eCollection 2024 Dec.
Neuroblastoma (NB) is a common extracranial solid tumor in children, often requiring surgical resection. Post-resection NB near the spine can lead to spinal deformities, but treatment strategies are not well-documented.
We retrospectively reviewed our patients who developed spinal deformities after NB resection at our hospital from 2013 to 2021. Treatment included the traditional growing rod (TGR) technique for patients with growth potential, posterior spinal fusion (PSF) for skeletally mature patients, and intermittent cast therapy for infants.
Five female patients underwent chemotherapy and surgical resection for NB, with no recurrence during follow-up. Single curves were seen in Cases 1, 2, 4, and 5, and Case 3 had double curves. NB tumors were on the convex side in Cases 1, 3, and 5, and on the concave side in Cases 2 and 4. TGR was used for Cases 1 and 2 due to growth potential and inadequate height. PSF was chosen for Cases 3 and 4, achieving satisfactory scoliosis and kyphosis correction. Case 5, diagnosed with scoliosis at 16 months, underwent intermittent cast therapy for 2 years, significantly correcting scoliosis and avoiding surgery. The average time from NB resection to scoliosis onset was 65.2 ± 49.3 months, with scoliosis treatment starting at 82.6 ± 58.1 months. The mean follow-up was 38.2 ± 12.1 months. All patients showed significant improvement in spinal deformities, with no significant correction loss at the last follow-up.
After NB resection, spinal deformities should be closely monitored, with intervention preferably within 6 months of discovery. TGR, PSF, and casting are effective interventions, with the treatment modality based on the patient's skeletal maturity and height.
神经母细胞瘤（NB）是儿童常见的颅外实体瘤，常需手术切除。脊柱附近的NB切除术后可导致脊柱畸形，但治疗策略尚无充分文献记载。
我们回顾性分析了2013年至2021年在我院接受NB切除术后发生脊柱畸形的患者。治疗方法包括对有生长潜力的患者采用传统生长棒（TGR）技术，对骨骼成熟的患者采用后路脊柱融合术（PSF），对婴儿采用间歇性支具治疗。
5例女性患者因NB接受化疗和手术切除，随访期间无复发。病例1、2、4和5为单曲线，病例3为双曲线。病例1、3和5的NB肿瘤位于凸侧，病例2和4的NB肿瘤位于凹侧。病例1和2因有生长潜力且身高不足而采用TGR。病例3和4选择PSF，脊柱侧凸和后凸畸形矫正效果满意。病例5在16个月时被诊断为脊柱侧凸，接受了2年的间歇性支具治疗，脊柱侧凸得到显著矫正，避免了手术。从NB切除到脊柱侧凸发病的平均时间为65.2±49.3个月，脊柱侧凸治疗开始时间为82.6±58.1个月。平均随访时间为38.2±12.1个月。所有患者脊柱畸形均有显著改善，末次随访时无明显矫正丢失。
NB切除术后，应密切监测脊柱畸形，最好在发现后6个月内进行干预。TGR、PSF和支具治疗是有效的干预措施，治疗方式根据患者的骨骼成熟度和身高而定。
