儿童与青少年脊柱骨母细胞瘤

Osteoblastoma of the spine in children and adolescent

目的探讨儿童与青少年脊柱骨母细胞瘤的临床特点、诊断与治疗。方法青少年脊柱骨母细胞瘤7例（男4例，女3例），平均年龄12．3岁（7～17岁）。颈椎3例、胸椎1例、腰椎3例。主要症状体征包括局部疼痛、椎旁肌痉挛僵硬、神经症状、脊柱侧弯。肿瘤均起源于椎弓。出现症状至诊断明确时间平均16个月。首次均采用后路手术，3例行固定融合重建。结果100％患儿局部疼痛；85．7％患儿存在椎旁肌僵硬；71．4％患儿有神经症状；57．1％存在不同程度侧弯。术中与术后无并发症。所有患儿获得随访，平均26个月。2例术后复发与再手术3人次。最后随访时均无症状及复发。结论儿童与青少年脊柱骨母细胞瘤典型表现是痛性脊柱侧弯，椎旁肌痉挛僵硬与神经症状发生率高。完全切除肿瘤才能获得满意疗效与防止复发。

Objective To study the clinical features, diagnosis and management of osteoblastoma of the spine in children and adolescent. Methods There were 7 cases, 4 male and 3 female, with mean age 12. 3 years （7 to 17 years）. The tumors of three patients were in cervical spine, one in thoracic, three in lumbar. The main clinic appearances included pain, marked spinal stiffness, neurological symptoms, and scoliosis. All tumors originated from vertebral arch. The average period to make a definite diagnosis was 16 months. Surgical approach in all patients was posterior in first surgery and three cases had fixation and fusion. Results All patients had local pain, marked spinal stiffness in 85. 7% cases, neurological symptom in 71.4%, and scoliosis in 57. 1%. There were no perioperative complications. The average follow-up was 26 months. The tumors recurred three times in 2 cases and were resected again. All patients had no symptom and recurrence at final follow-ups. Conclusions The typical manifestation of osteoblastoma of the spine in children and adolescent is painful scoliosis. There are high ratios of marked spinal stiffness and neurological symptoms. Complete resection is necessary to gain satisfactory outcomes and prevent recurrence.