Mammano S, Candiotto S, Balsano M
Institute of Orthopaedics, University of Padova, Italy.
J Pediatr Orthop. 1997 Nov-Dec;17(6):821-7.
Eosinophilic granuloma of the skeleton is rarely reported in the literature. The incidence of vertebral involvement varies between 7.8 and 25% and it is generally a solitary lesion, with a predilection for the male sex in the first decade of life. The prognosis is favorable also for the vertebral body's tendency for reconstruction. A recovery of the somatic structure is apparently much improved by eliminating or reducing mechanical stress by means of bed rest and the use of plaster casts or braces. We examined nine patients treated at the Orthopedics Clinic of Padova University, and with a follow-up of > or = 10 years. treated with plaster casts and spinal orthoses. The study was based on the modified Nesbit radiographic classification in 4 grades of severity depending on the height of the vertebral body involved. Long-term follow-up revealed no painful symptoms and a virtually total recovery of somatic structure in five cases, whereas four patients still showed a varying degree of somatic alteration. The osteogenic capacity of the intact ring epiphysis and ossifying metaplastic processes were assumed to be the mechanisms contributing, together with a reduced mechanical load, to reconstruction of the vertebral somatic structure.
骨骼嗜酸性肉芽肿在文献中鲜有报道。椎体受累的发生率在7.8%至25%之间，通常为单发病变，好发于10岁前的男性。由于椎体具有重建的倾向，其预后良好。通过卧床休息以及使用石膏或支具消除或减轻机械应力，躯体结构的恢复显然会得到很大改善。我们对帕多瓦大学骨科诊所治疗的9例患者进行了检查，随访时间≥10年，这些患者接受了石膏和脊柱矫形器治疗。该研究基于改良的内斯比特放射学分类法，根据受累椎体的高度将严重程度分为4级。长期随访显示，5例患者无疼痛症状，躯体结构几乎完全恢复，而4例患者仍有不同程度的躯体改变。完整的环状骨骺的成骨能力和骨化化生过程被认为是与机械负荷减轻共同促成椎体躯体结构重建的机制。
