背景:骨样骨瘤(OO)是一种常见的良性骨肿瘤;然而,大约25%的病例有脊柱受累。通常通过图像引导的射频消融来治疗,以分解病灶。很少有报道描述了病变的完全内窥镜切除,但是没有人描述手术切除OO后腰椎小关节的术后重塑。该研究旨在描述腰椎小关节重塑的罕见情况,然后描绘内窥镜切除OO的侵入性最小的手术技术。
方法:一名26岁男子出现严重的左臀部疼痛和坐骨神经痛,夜间加重,布洛芬缓解。磁共振成像显示L3肿块样病变的左下小面。薄切片的计算机断层扫描图像显示了一个nidus,与OO兼容。进行了完全内窥镜切除以完全去除OO的病灶。
结果:在2年的随访中,患者无症状,计算机断层扫描图像提示新骨形成.
结论:目前的病例和文献综述表明,内窥镜切除对于治疗腰椎OO的后部是安全有效的。此外,该技术允许在对周围结构损伤最小的情况下完全切除病灶,并导致切除部位重塑.
结论:OO累及脊柱后部的患者可出现臀部和神经根疼痛,模仿腰椎间盘突出症。OO可以通过完整的内窥镜方法成功去除,并且可以预期切除部位的重塑。
BACKGROUND: Osteoid osteoma (OO) is a common benign bone tumor; however, approximately 25% of cases have spine involvement. It is often treated by image-guided radiofrequency ablation to break down the nidus. Few
reports have described full endoscopic resection of the lesion, but none have described postoperative
remodeling of the lumbar facet joint after surgical resection of an OO. The study aimed to describe a rare
case of
remodeling of the lumbar facet joint and then delineate the least invasive surgical technique of endoscopic resection of an OO.
METHODS: A 26-year-old man presented with severe left buttock pain and sciatica that worsened at night and was relieved by ibuprofen. Magnetic resonance imaging indicated a left inferior facet of an L3 mass-like lesion. A thin-section computed tomography image revealed a nidus, which was compatible with an OO. Full endoscopic resection was performed to completely remove the nidus of the OO.
RESULTS: At the 2-year follow-up, the patient was symptom-free and computed tomography images indicated new bone formation.
CONCLUSIONS: The present
case and literature review demonstrate that endoscopic resection is safe and effective for managing a posterior element of lumbar OO. Furthermore, this technique allows complete removal of the nidus with minimal damage to surrounding structures and leads to remodeling of the resection site.
CONCLUSIONS: Patients with OO involving the posterior element of the spine can present with buttock and radicular pain, mimicking lumbar disc herniation. OO can be successfully removed by the full endoscopic method and
remodeling of the resected site can be anticipated.
METHODS: