Saifuddin A, White J, Sherazi Z, Shaikh M I, Natali C, Ransford A O
Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, England.
Spine (Phila Pa 1976). 1998 Jan 1;23(1):47-53. doi: 10.1097/00007632-199801010-00010.
A retrospective study of 44 museum cases of spinal osteoid osteoma or osteoblastoma and a meta-analysis using 421 additional cases from a review of the literature.
To identify the factors that are associated with the development of scoliosis in these patients.
Painful scoliosis is a well recognized presentation of spinal osteoid osteoma and osteoblastoma and is considered to be secondary to pain-provoked muscle spasm on the side of the lesion. Previous studies have been based on small numbers of patients that did not permit statistical validation of the reported observations.
Eight factors were assessed including: age, gender, duration of symptoms, site of lesion in the spine, vertebral level of lesion, site of lesion in the individual vertebra, type of lesion, and Cobb angle at presentation. Reports were reviewed only if the presence or absence of scoliosis could be determined. Statistical analyses initially were performed on the museum cases and then on a combination of museum cases and cases from the literature.
Overall, 63% of subjects had scoliosis. The lesions were typically present on the concave aspect of the curve. Three cases of scoliosis from the literature involved lesions that were reported to be on the convexity. Scoliosis is significantly more common in cases of osteoid osteoma than in cases of osteoblastoma (P < 0.0001); lesions are more common in the thoracic and lumbar regions than in the cervical region (P < 0.0001), in lower cervical region than in the upper cervical region (P value = 0.0027), and they are more commonly located to one side of the midline (P < 0.0001). Age, gender, and duration of symptoms were of no significance.
The findings support the concept that scoliosis is secondary to asymmetric muscle spasm in patients with spinal osteoid osteoma or osteoblastoma.
对44例博物馆收藏的脊柱骨样骨瘤或骨母细胞瘤病例进行回顾性研究，并对文献综述中另外421例病例进行荟萃分析。
确定与这些患者脊柱侧弯发展相关的因素。
疼痛性脊柱侧弯是脊柱骨样骨瘤和骨母细胞瘤的一种公认表现，被认为是由病变侧疼痛引发的肌肉痉挛所致。以往研究基于少量患者，无法对报告的观察结果进行统计学验证。
评估八个因素，包括：年龄、性别、症状持续时间、脊柱病变部位、病变椎体水平、单个椎体的病变部位、病变类型以及就诊时的Cobb角。仅在能够确定是否存在脊柱侧弯的情况下对报告进行审查。最初对博物馆病例进行统计分析，然后对博物馆病例和文献中的病例进行综合分析。
总体而言，63%的受试者有脊柱侧弯。病变通常出现在侧弯的凹侧。文献中的三例脊柱侧弯病例涉及据报道位于凸侧的病变。脊柱侧弯在骨样骨瘤病例中比在骨母细胞瘤病例中明显更常见（P < 0.0001）；病变在胸段和腰段比在颈段更常见（P < 0.0001），在下颈段比在上颈段更常见（P值 = 0.0027），并且它们更常位于中线一侧（P < 0.0001）。年龄、性别和症状持续时间无显著意义。
这些发现支持了脊柱侧弯是脊柱骨样骨瘤或骨母细胞瘤患者不对称肌肉痉挛所致的观点。
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