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目的 探讨用微创技术治疗骨样骨瘤的适应证和方法，并判断其疗效。方法 1996年 1月～ 1998年 7月， 7例肢体骨样骨瘤患者采用 CT引导下经皮病灶磨除术，年龄 13～ 29岁，所有患者均有典型的临床表现、 X线及 CT扫描的特殊改变。在患肢病灶表面放置金属标志，经 CT扫描确定体表标志与瘤巢间的距离与最佳穿刺角度。在 CT引导监视下，穿克氏针，顺克氏针置入前缘带齿的套筒，将变速磨钻的磨头导入瘤巢内，磨除瘤巢并磨穿对侧硬化骨。部分病例的磨除标本经组织病理学检查证实为骨样骨瘤。结果 6例患者一次手术成功（瘤巢磨除、症状消失、影像学证实）， 1例肱骨干骺端处骨样骨瘤的瘤巢未被完全磨除而症状复发，经二次手术磨除成功。无较大的手术并发症发生。随访 18～ 35个月 (平均 25.1个月 )，临床症状消失； X线片示瘤巢消失，硬化骨范围缩小。结论 CT引导下经皮磨除肢体骨样骨瘤是一种安全、有效、费用较低且精确度较高的微创手术，适用于所有肢体长骨的骨样骨瘤。
Objective To explore the indications and methods of minimally invasive treatment of osteoid osteoma and to determine its efficacy. Methods From January 1996 to July 1998, 7 cases of limb osteoid osteoma were treated by CT guided percutaneous lesion, aged 13 to 29 years. All patients had typical clinical manifestations, X-ray and CT scan Special changes. Placed in the affected limb lesions on the surface of the metal mark, the CT scan to determine the distance between the body surface markers and neoplasms and the best puncture angle. Under the guidance of CT guidance, the Kirschner wire and the Kirschner wire were inserted into the toothed sleeve with a toothed head. The grinding head of the variable speed grinding drill was introduced into the neoplasm, and the tumor nests were removed and worn through the contralateral sclerosis bone. In some cases, ablated specimens confirmed by histopathology as osteoid osteoma. Results Six cases were successfully surgically removed (neoplasm removed, the symptoms disappeared and the imaging confirmed). One case of osteoid osteoma of the humeral metaphysis was not completely ablated and the tumor was recurred. The second surgical ablation success. No major surgical complications occurred. The follow-up ranged from 18 to 35 months (average 25.1 months), and clinical symptoms disappeared. X-ray showed disappearance of tumor nests and reduction of sclerosis bone. Conclusion CT guided percutaneous osteotome osteotomy is a safe, effective, less expensive and more accurate minimally invasive surgery for all the long bones of osteoid osteoma.