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目的:探讨颈椎骨样骨瘤的诊断及手术治疗效果。方法:1999年12月～2008年6月我院手术治疗颈椎骨样骨瘤患者6例,男、女各3例,年龄7～37岁,平均17.8岁。均有颈痛,伴斜颈畸形2例,上肢放射性疼痛及麻木3例。颈椎X线平片仅2例发现病灶。均行颈椎CT扫描显示肿瘤为局部膨胀性病变、低密度或不均密度,伴有边缘硬化。4例患者行核素骨扫描检查,病损均有放射性浓聚。寰椎侧块1例;下颈椎5例,其中C51例、C63例、C71例;1例累及C6椎体,其余均累及椎弓根、椎板和/或关节突等后方结构。均行手术切除肿瘤,边缘切除5例,其中后路侧块固定4例,前路椎间植骨钛板固定1例;瘤内刮除植骨1例。结果:手术时间1.5～4.5h,平均2.8h;术中出血量50～400ml,平均233ml。术后颈痛和神经根损害表现均消失,斜颈畸形得到纠正,无手术相关并发症。随访12～108个月,平均42.5个月,均无颈痛症状,末次随访时CT检查无肿瘤复发;5例内固定患者无内固定松动或断裂,其中1例术后2年拆除侧块固定;2例植骨患者植骨块均融合。结论:颈椎骨样骨瘤多发于年轻患者,除颈痛外,亦可有斜颈、神经功能受损表现;颈椎CT联合核素骨扫描检查对诊断有重要意义;有长期颈痛、神经功能受损或斜颈时应积极手术治疗,边缘切除可获得良好效果。
Objective: To investigate the diagnosis and surgical treatment of cervical osteoid osteoma. Methods: From December 1999 to June 2008, 6 cases of cervical osteoid osteoma were treated in our hospital. There were 3 males and 3 females, aged 7 to 37 years (average 17.8 years). Both had neck pain, with torticollis malformation in 2 cases, upper limb radiating pain and numbness in 3 cases. Only two cases of cervical X-ray lesions were found. Cervical CT scan showed that the tumor was locally dilated lesions, low density or uneven density, with edge hardening. Four patients underwent radionuclide bone scintigraphy, lesions were radioactively concentrated. 1 case of atlas lateral mass, 5 cases of lower cervical vertebrae, including C51 cases, C63 cases and C71 cases. One case involved the C6 vertebrae. The rest involved the posterior structures such as pedicle, lamina and / or articular processes. All patients underwent resection of the tumor and marginal resection in 5 cases. Among them, 4 cases were fixed in the posterior lateral mass and 1 in the anterior intervertebral bone graft. Results: The operation time was 1.5-4.5 hours, with an average of 2.8 hours. The intraoperative blood loss was 50-400ml, with an average of 233ml. Postoperative neck pain and nerve root damage performance disappeared, torticollis deformity corrected, no surgical complications. All cases were followed up for 12 to 108 months with an average of 42.5 months. No neck pain was found. There was no tumor recurrence on the CT scan at the last follow-up. Five cases of internal fixation had no loosening or rupture of the internal fixation, of which 1 case had lateral block fixation 2 patients with bone graft fusion. Conclusions: Cervical osteoid osteoma is more common in young patients. In addition to neck pain, torticollis and neurological deficits may be seen. Cervical CT and radionuclide bone scan are important for diagnosis. There are long-term neck pain, neurological function Should be actively surgical treatment of damaged or torticollis, marginal resection can get good results.