儿童脊椎嗜酸性肉芽肿的诊断鉴别诊断与手术治疗

Diagnosis,differential diagnosis and surgical treatment of children with vertebral eosinophilic granuloma

目的探讨儿童脊柱嗜酸性肉芽肿(eosinophilic granuloma,EG)的诊断、鉴别诊断及治疗方法的选择。方法在广泛查阅儿童脊椎EG的相关文献的基础上,结合本科经手术病理证实的脊柱EG患儿1例,综合分析该病症的诊断、鉴别诊断与治疗方法。结果儿童脊椎EG临床症状与影像学表现不一致,而且其与脊柱结核、脊柱良恶性肿瘤、化脓性脊柱炎等影像学表现有相似处,容易误诊,确诊有赖于病理检查。结论儿童脊椎EG需要根据其临床特点、影像学检查及病理检查三者结合起来进行确定诊断同时只有根据病人发病部位、脊柱破坏的程度及合并症实行个体化治疗才能取得好的治疗效果。

Objective To investigate the diagnosis,differential diagnosis and surgical treatment of children with vertebral eosinophilic granuloma.Methods On the basis of reviewing the references about vertebral eosinophilic granuloma of home and abroad,together with one case confirmed by surgery and pathology in our hospital,the diagnosis, differential diagnosis and surgical treatment of this disease were analyzed and summarized.Results The imaging findings of vertebral EG were not consistent with the clinical symptoms.Furthermore,its imaging had some similarity to vertebral tuberculosis,spinal tumor and pyogenic spondylitis.Therefore,EG is easy to misdiagnose and should be confirmed by pathology.Conclusion The diagnosis of vertebral EG should be made based on the clinical characters, imaging and pathology.Individualized treatment plan for each patient should be made based on the EG location,the damage degree of vertebrae and the complications.Only such individualized treatment can achieve the desired therapeutic effect.