髋关节周围骨样骨瘤的CT引导下经皮旋切治疗

CT-guided percutaneous removal of osteoid osteoma around the hip joint

目的探讨CT引导下髋关节周围骨样骨瘤经皮旋切治疗的疗效。方法2006年5月至2008年12月,共收治8例髋关节周围骨样骨瘤患者,其中男5例,女性3例,年龄8～28岁,平均18.4岁,临床表现及影像资料均支持骨样骨瘤诊断,均于CT引导下经行皮骨样骨瘤旋切术。术前对整个病灶区采用1～2mm薄层CT扫描,然后选择瘤巢中心,于导引针引导下行环锯完全切除瘤巢。结果8例患者均顺利取出瘤巢,3例手术后症状缓解,5例手术后次日症状缓解,无明显手术并发症发生。随访6～24个月(平均14.6个月),患者症状完全缓解,无1例复发。结论CT引导下经皮旋切髋关节周围骨样骨瘤治疗微创、简便、安全、疗效确定,有助于手术安全及患者快速康复。

Objective To evaluate the methods of CT-guided percutaneous removal of osteoid osteoma around the hip joint.Methods From May 2006 to December 2008,there were 8 patients,at a mean age of 18.4 years（from 8 to 28 years）.Five cases were male,and 3 cases were female.Diagnosis was supported by the complete clinical and imaging file.Eight cases with osteoid osteomas were treated with CT-guided percutaneous excision.CT scanning was done in the whole nidus with thin slices（1～2 mm thick）,and the CT scan slice passing through the center of the nidus was selected.Then the whole nidus was removed by trephine along the guide wire which was inserted into the bone up to the nidus and was protected by the trocar.Finally complete lesion resection was checked with CT.Results Seven cases had a final pathological diagnosis of osteoid osteomas.Complete pain relief was obtained in these patients after the day of operation.There were no complications,no recurrence and patients remained symptom free at follow-up of 6～24 months（mean 14.6 months）.Conclusion The methods of CT guided percutaneous removal of osteoid osteoma around the hip joint is a minimally invasive technique that represents the efficacy and safety.