Osteoid osteoma

骨样骨瘤
  • 文章类型: Journal Article
    目的:经皮CT引导射频消融(CT-RFA)是一种广泛接受的骨样骨瘤治疗方法。然而,由于存在一些弊端,CT-RFA的应用受到限制,例如辐射暴露,和全身麻醉的不便。这项研究的主要目的是评估TiRobot辅助的骨样骨瘤术中经皮RFA的安全性和有效性。
    方法:我们回顾性回顾了2021年3月至2022年4月在我们机构接受TiRobot系统引导下的骨样骨瘤经皮RFA治疗的21例患者的医疗档案。通过3DC臂在术中获得的三维图像被发送到TiRobot系统。设计了穿刺点和轨迹。然后在TiRobot的辅助下将引导销定位到病变处,并通过引导销将活检鞘插入病变中。对肿瘤进行活检以进行病理检查。然后通过活检鞘将RFA针插入病灶内进行热消融。提取相关并发症的数据,通过视觉模拟评分(VAS)评估术后1个月和1年的疼痛减轻。采用配对t检验比较术前、术后VAS评分。
    结果:患者包括17名男性和4名女性,平均年龄为19.5±10.4岁(范围3-45岁)。9例病变位于股骨,在9例胫骨上,在一个案例中,肱骨上,在一个案例中,跟骨上,在一个案例中,髋臼上。TiRobot辅助经皮RFA对所有21例患者均成功进行。未观察到术中或术后并发症。11例骨样骨瘤的病理诊断,但其他10例没有病理诊断。随访时间12~26个月,平均18.8个月。术后VAS评分均显著降低。平均VAS评分从术前的6.5降至术后1个月的0.5,术后1年的0.1。
    结论:作为定位和切除病灶的可靠技术,TiRobot辅助经皮RFA是治疗骨样骨瘤的安全有效选择。
    OBJECTIVE: Percutaneous CT-guided radiofrequency ablation (CT-RFA) is a widely accepted procedure for treatment of osteoid osteomas. However, the application of CT-RFA was restricted as a result of some drawbacks, such as radiation exposure, and inconvenience in general anesthesia. The primary aim of this study is to evaluate the safety and efficacy of intra-operative TiRobot-assisted percutaneous RFA of osteoid osteomas.
    METHODS: We retrospectively reviewed 21 medical files of patients who were treated with percutaneous RFA of osteoid osteomas guided by the TiRobot system in our institution between March 2021 and April 2022. The three-dimensional images obtained by a 3D C-arm intra-operatively were sent to the TiRobot system. The puncture point and trajectory were designed. Then the guide pin was positioned to the lesion with the assistance of TiRobot and the biopsy sheath was inserted into the lesion through the guide pin. The tumor was biopsied for pathological examination. Then the RFA needle was inserted into the nidus through the biopsy sheath for thermal ablation. Data were extracted on the associated complications, the reduction in pain at 1 month and 1 year postoperatively assessed by the visual analogue scale (VAS). A paired t-test was used to compare the pre-operative and post-operative VAS scores.
    RESULTS: The patients included 17 males and four females with a mean age of 19.5 ± 10.4 years (range 3-45 years). Lesions were located on the femur in nine cases, on the tibia in nine cases, on the humerus in one case, on the calcaneus in one case, and on the acetabulum in one case. TiRobot-assisted percutaneous RFA was successfully performed on all 21 patients. There was no intra-operative or post-operative complications observed. Pathological diagnosis of osteoid osteoma was obtained in 11 patients, but the other 10 cases were not pathologically diagnosed. The mean follow-up time was 18.8 months (range: 12-26 months).Post-operative VAS scores were reduced significantly in all cases. The mean VAS score decreased from 6.5 pre-operatively to 0.5 at 1 month post-operatively and to 0.1 at 1 year post-operatively.
    CONCLUSIONS: As a reliable technique for localizing and resection of nidus, TiRobot-assisted percutaneous RFA is a safe and effective option for the treatment of osteoid osteomas.
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  • 文章类型: English Abstract
    UNASSIGNED: To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma.
    UNASSIGNED: A clinical data of 36 patients with limb osteoid osteomas admitted between June 2016 and June 2023 was retrospectively analyzed. Among them, 16 patients underwent orthopaedic robot-assisted minimally invasive surgery (robot-assisted surgery group), and 20 patients underwent tumor resection after lotcated by C-arm X-ray fluoroscopy (open surgery group). There was no significant difference between the two groups in the gender, age, lesion site, tumor nidus diameter, and preoperative pain visual analogue scale (VAS) scores ( P>0.05). The operation time, lesion resection time, intraoperative blood loss, intraoperative fluoroscopy frequency, lesion resection accuracy, and postoperative analgesic use frequency were recorded and compared between the two groups. The VAS scores for pain severity were compared preoperatively and at 3 days and 3 months postoperatively.
    UNASSIGNED: Compared with the open surgery group, the robot-assisted surgery group had a longer operation time, less intraoperative blood loss, less fluoroscopy frequency, less postoperative analgesic use frequency, and higher lesion resection accuracy ( P<0.05). There was no significant difference in lesion resection time ( P>0.05). All patients were followed up after surgery, with a follow-up period of 3-24 months (median, 12 months) in the two groups. No postoperative complication such as wound infection or fracture occurred in either group during follow-up. No tumor recurrence was observed during follow-up. The VAS scores significantly improved in both groups at 3 days and 3 months after surgery when compared with preoperative value ( P<0.05). The VAS score at 3 days after surgery was significantly lower in robot-assisted surgery group than that in open surgery group ( P<0.05). However, there was no significant difference in VAS scores at 3 months between the two groups ( P>0.05).
    UNASSIGNED: Compared with open surgery, robot-assisted resection of limb osteoid osteomas has longer operation time, but the accuracy of lesion resection improve, intraoperative blood loss reduce, and early postoperative pain is lighter. It has the advantages of precision and minimally invasive surgery.
    UNASSIGNED: 比较骨科机器人辅助微创手术与开放手术切除肢体骨样骨瘤的准确性与疗效。.
    UNASSIGNED: 回顾分析2016年6月—2023年6月收治的36例肢体骨样骨瘤患者临床资料,其中16例选择骨科机器人辅助微创切除瘤巢手术(机器人手术组),20例采用常规C臂X线机透视定位后切除肿瘤(开放手术组)。两组患者性别、年龄、病灶部位、瘤巢直径以及术前疼痛视觉模拟评分(VAS)等基线资料比较,差异均无统计学意义( P>0.05)。记录并比较两组手术时间、病灶切除时间、术中出血量、术中透视次数、病灶切除准确度、术后止痛药使用次数,以及术前及术后3 d、3个月疼痛程度(VAS评分)。.
    UNASSIGNED: 与开放手术组相比,机器人手术组手术时间延长,但术中出血量、透视次数及术后止痛药使用次数均减少,病灶切除准确度提高,差异均有统计学意义( P<0.05);病灶切除时间差异无统计学意义( P>0.05)。两组患者术后均获随访,随访时间均为3~24个月,中位时间均为12个月。术后两组均无切口感染、骨折等并发症发生。随访期间均无肿瘤复发。两组患者术后3 d、3个月时VAS 评分均较术前改善( P<0.05);术后3 d机器人手术组VAS评分较开放手术组更低( P<0.05),但术后3个月VAS评分组间差异无统计学意义( P>0.05)。.
    UNASSIGNED: 与开放手术相比,骨科机器人辅助下切除肢体骨样骨瘤虽然手术时间延长,但病灶切除准确度提高、术中出血量减少、术后早期疼痛程度更轻,具有精准、微创优势。.
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  • 文章类型: English Abstract
    UNASSIGNED: To investigate short-term effectiveness and clinical application advantages of orthopedic robot-assisted resection for osteoid osteoma compared with traditional open surgery.
    UNASSIGNED: A retrospective analysis was conducted on clinical data of 48 osteoid osteoma patients who met the selection criteria between July 2022 and April 2023. Among them, 23 patients underwent orthopedic robot-assisted resection (robot-assisted surgery group), and 25 patients received traditional open surgery (traditional surgery group). There was no significant difference ( P>0.05) in gender, age, disease duration, lesion location and size, and preoperative visual analogue scale (VAS) score, and musculoskeletal tumor society (MSTS) score between the two groups. The surgical time, intraoperative blood loss, intraoperative lesion localization time, initial localization success rate, infection, and recurrence were recorded and compared. VAS scores before surgery and at 24 hours, 1, 3, 6, and 9 months after surgery and MSTS score before surgery and at 3 months after surgery were assessed.
    UNASSIGNED: All patients completed the surgery successfully, with no significant difference in surgical time between the two groups ( P>0.05). Compared to the traditional surgery group, the robot-assisted surgery group had less intraoperative blood loss, shorter lesion localization time, and shorter hospitalization time, with significant differences ( P<0.05). The initial localization success rate was higher in the robot-assisted surgery group than in the traditional surgery group, but the difference between the two groups was not significant ( P>0.05). All patients in both groups were followed up, with the follow-up time of 3-12 months in the robot-assisted surgery group (median, 6 months) and 3-14 months in the traditional surgery group (median, 6 months). The postoperative MSTS scores of both groups improved significantly when compared to those before surgery ( P<0.05), but there was no significant difference in the changes in MSTS scores between the two groups ( P>0.05). The postoperative VAS scores of both groups showed a gradually decreasing trend over time ( P<0.05), but there was no significant difference between the two groups after surgery ( P>0.05). During follow-up, except for 1 case of postoperative infection in the traditional surgery group, there was no infections or recurrences in other cases. There was no significant difference in the incidence of postoperative infection between the two groups ( P>0.05).
    UNASSIGNED: Orthopedic robot-assisted osteoid osteoma resection achieves similar short-term effectiveness when compared to traditional open surgery, with shorter lesion localization time.
    UNASSIGNED: 通过与传统开放手术比较,探讨骨科机器人辅助骨样骨瘤切除的早期疗效以及临床应用优势。.
    UNASSIGNED: 回顾性分析2022年7月—2023年4月符合选择标准的48例骨样骨瘤患者临床资料,其中23例接受骨科机器人辅助骨样骨瘤切除手术(机器人辅助手术组),25例行传统开放手术(传统手术组)。两组患者性别、年龄、病程、病灶部位及最大径、术前疼痛视觉模拟评分(VAS)及美国肌肉骨骼肿瘤学会(MSTS)评分比较,差异均无统计学意义( P>0.05)。记录并比较两组手术时间、术中出血量、术中病灶定位时间与初次定位成功率、住院时间以及术后感染、肿瘤复发情况;术前以及术后24 h,1、3、6、9个月 VAS评分,术前及术后3个月MSTS评分。.
    UNASSIGNED: 两组手术均顺利完成,手术时间差异无统计学意义( P>0.05)。与传统手术组相比,机器人辅助手术组术中出血量减少、病灶定位时间及住院时间均缩短,差异有统计学意义( P<0.05);初次定位成功率更高,但差异无统计学意义( P>0.05)。两组患者均获随访,其中机器人辅助手术组随访时间3~12个月,中位时间6个月;传统手术组为3~14个月,中位时间6个月。两组术后MSTS评分均较术前改善( P<0.05),但组间MSTS评分变化值差异无统计学意义( P>0.05)。两组术后VAS评分均随时间延长呈逐渐降低趋势( P<0.05),但术后两组间比较差异均无统计学意义( P>0.05)。随访期间,除传统手术组1例发生术后感染外,其余均未发生感染及肿瘤复发;两组术后感染发生率差异无统计学意义( P>0.05)。.
    UNASSIGNED: 与传统开放手术相比,骨科机器人辅助下骨样骨瘤切除术不仅能获得相似早期疗效,且术中病灶定位时间更短。.
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  • 文章类型: Meta-Analysis
    目的:磁共振引导聚焦超声(MRgFUS)是一种新型的非侵入性骨样骨瘤(OO)介入技术。这项研究的目的是通过对MRgFUS治疗前后疼痛评分和治疗后不良事件的系统评价和荟萃分析,评估MRgFUS治疗OO的有效性和安全性。
    方法:对PubMed,Embase,WebofScience,和CochraneLibrary数据库进行筛选,根据纳入和排除标准筛选研究文献,以提取和分析治疗前后的疼痛评分数据,成功率(完全缓解疼痛,直到最后一次随访才复发),复发率,二级干预率,和并发症,以评估MRgFUS用于OO的疗效和/或安全性。
    结果:共收集了2012年至2022年间发表的113项研究,导致总样本量为353名患者。大多数研究是前瞻性的,随访时间为4周或更长时间,总的来说,证据质量从低到高不等。合并后1周和1个月疼痛评分分别为0.62(9.5%CI:0.28-0.96)和0.37(9.5%CI:0.07-0.68),分别。组合的成功率为92.8%(95%CI:89.8%-95.7%),轻微并发症(消融部位热损伤)的发生率为0.85%,纳入的任何文献均未记录到重大并发症.
    结论:MRgFUS是一种有效的方法,能够治疗OO患者的疼痛,具有令人满意的疗效和安全性。
    编号.CRD42023415573。
    OBJECTIVE: Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive interventional technique for osteoid osteoma (OO). The purpose of this study was to evaluate the efficacy and safety of MRgFUS in the treatment of OO through a systematic review and meta-analysis of pain scores and post-treatment adverse events before and after MRgFUS treatment.
    METHODS: A comprehensive literature search of PubMed, Embase, Web of science, and Cochrane Library databases was conducted to screen the study literature based on inclusion and exclusion criteria to extract and analyze pre- and post-treatment pain score data, success rates (complete pain relief with no recurrence until the last follow-up), recurrence rates, secondary intervention rates, and complications to evaluate the efficacy and/or safety of MRgFUS for OO.
    RESULTS: A total of 113 studies published between 2012 and 2022were collected, resulting in a total sample size of 353 patients. The majority of the studies were prospective and had a follow-up period of 4 weeks or more, and overall, the quality of evidence ranged from low to high. Pain scores at 1 week and 1 month after the merger were 0.62 (9.5% CI:0.28-0.96) and 0.37 (9.5% CI:0.07-0.68), respectively. The success rate of the combination was 92.8% (95% CI: 89.8%-95.7%), the incidence of minor complications (thermal injury at the ablation site) was 0.85%, and no major complications were recorded in any of the included literature.
    CONCLUSIONS: MRgFUS is an effective procedure that is able to treat pain for patients with OO with satisfying efficacy and safety.
    UNASSIGNED: No.CRD42023415573.
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  • 文章类型: Case Reports
    鼻骨母细胞瘤(OB)是一种罕见的局部侵袭性成骨性肿瘤,至今鲜有报道。并且缺乏有效的诊断和治疗证据数据。在这项研究中,我们报告了1例31岁女性患者,表现为鼻塞和相关的左侧颌面部进行性无痛性肿胀.进行了鼻旁窦的术前计算机断层扫描(CT)检查,根据成像演示,外科医生无法区分OB,骨样骨瘤(OO),骨纤维发育不良(FDB)和成骨细胞纤维瘤(OF)。排除手术禁忌症后,患者接受了鼻内镜下左侧鼻肿块切除术,它被发现是砾石状的,在操作过程中很难清除干净。质量很脆,容易流血,导致手术区域暴露不足,延长操作时间,术中大量失血。这表明明确的术前诊断(建议对肿块的较深部分进行活检)和适当的术前准备(例如,术前血管造影和栓塞,充足的血液准备)非常重要。术中冰冻及术后病理结果明确肿瘤为OB。术后随访11个月,未观察到肿瘤局部复发。
    Nasal osteoblastoma (OB) is a rare and locally aggressive osteogenic tumor that has rarely been reported, and there is a lack of effective evidence data for its diagnosis and treatment. In this study, we report a 31-year-old female patient who presented with nasal congestion and associated progressive painless swelling of the left maxillofacial region. A preoperative computed tomography (CT) examination of the paranasal sinuses was performed, and based on the imaging presentation, the surgeon was unable to differentiate between OB, osteoid osteoma (OO), fibrous dysplasia of bone (FDB) and osteoblastic fibroma (OF). After excluding contraindications to surgery, the patient underwent nasal endoscopic excision of the left nasal mass, which was found to be gravel-like and difficult to remove cleanly during the operation. The mass was brittle and bled easily, resulting in inadequate exposure of the operative field, prolonged operation time, and substantial intraoperative blood loss. This indicates that definite preoperative diagnosis (biopsy of deeper parts of the mass is recommended) and appropriate preoperative preparations (e.g., preoperative angiography and embolization, adequate blood preparation) are very important. The intraoperative frozen and postoperative pathological results clearly identified the tumor as OB. No local recurrence of the tumor was observed at the 11-month postoperative follow-up.
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  • 文章类型: Review
    楔形骨的骨样骨瘤是一种极为罕见且容易引起脚痛的原因。这种关节内骨样骨瘤的非特征性和非特异性X光片进一步增加了诊断的难度。迄今为止,在任何已发表的文献中,都没有关于中间楔形骨的关节内骨样骨瘤引起关节变性的描述。我们介绍了一例中间楔形骨的关节内骨样骨瘤,引起关节变性。接受刮宫的人,同种异体骨移植,和舟骨楔形关节固定术。患者表现为影像学骨愈合,在22个月的随访中,完全的运动功能恢复和无痛。此报告增加了现有文献。中间楔形骨的关节内骨样骨瘤导致关节变性是一种极为罕见且容易错过的脚痛原因。事实证明,识别关节内骨样骨瘤是一项复杂而具有挑战性的任务。临床医生应该特别小心,不要排除关节炎的可能性,因此,在选择手术时保持警惕。
    Osteoid osteoma of the cuneiform bone is an exceedingly rare and easily missed cause of foot pain. The uncharacteristic and nonspecific radiographs of such intra-articular osteoid osteoma further increase difficulty in making the diagnosis. To date, there has been no description of intra-articular osteoid osteoma of the intermediate cuneiform bone causing articular degeneration in any published literatures. We present a case of intra-articular osteoid osteoma of the intermediate cuneiform bone causing articular degeneration, who underwent curettage, allograft bone graft, and navicular-cuneiform arthrodesis. The patient presented with radiographic bone union, full motor function recovery and pain-free at the 22-month follow-up. This report adds to the existing literature. Intra-articular osteoid osteoma of the intermediate cuneiform bone causing articular degeneration is an exceedingly rare and easily missed cause of foot pain. It proves a complicated and challenging task to identify intra-articular osteoid osteoma. Clinicians should be particularly careful not to exclude the possibility of arthritis and, thus, vigilant when choosing the surgical option.
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  • 文章类型: Case Reports
    背景:骨样骨瘤是一种良性成骨肿瘤,主要发生在股骨干,而腰椎椎体中发生的骨样骨瘤是一种相对罕见的病例。尽量减少治疗相关的并发症,使用了计算机辅助导航完全可视化的脊柱内窥镜检查.最终,病理诊断为骨样骨瘤。
    方法:我们报告了一名19岁的成年男性,患有夜间和CT加重的腰痛,MRI成像显示腰椎椎体后缘有异常信号阴影。由于病变靠近椎管并靠近神经根,通过单纯的内窥镜或开放手术很难精确定位病变,如果有必要,周围组织的切除必须扩大,对周围组织造成不必要的损害。因此,我们选择计算机辅助导航全可视化脊柱内窥镜来进行治疗.
    结论:在这种情况下,我们报告了一种在腰椎椎体中发生频率较低的骨样骨瘤。使用计算机辅助导航和完全可视化的脊柱内窥镜检查,我们成功地切除了L3椎体后缘的骨样骨瘤术前通过计算机规划路径术中可视化内窥镜检查,尽量减少对脊柱稳定性的损害。带有可视化内窥镜的计算机辅助导航为脊柱骨样骨瘤的治疗提供了更精确和微创的方法。
    BACKGROUND: Osteoid osteoma is a benign osteogenic tumor that occurs mostly in the femoral stem, while osteoid osteoma occurring in the lumbar vertebral body is a relatively rare case. To minimize treatment-related complications, a computer-assisted navigation fully visualized spinal endoscopy was used. Ultimately, the pathology was diagnosed as osteoid osteoma.
    METHODS: We report a 19-year-old adult male with low back pain that worsened at night and CT, MRI imaging showed an abnormal signal shadow at the posterior margin of the lumbar vertebral body. Due to the proximity of the lesion to the spinal canal and adjacent to the nerve roots, it was difficult to precisely localize the lesion by purely endoscopic or open procedures, and if necessary, the resection of surrounding tissues had to be expanded, causing unnecessary damage to the surrounding tissues. Therefore, we choose computer-assisted navigation fully visualized spinal endoscopy to perform the treatment.
    CONCLUSIONS: In this case, we report an osteoid osteoma that occurs less frequently in the lumbar vertebral body. Using computer-assisted navigation with fully visualized spinal endoscopy, we successfully resected the osteoid osteoma at the posterior margin of the L3 vertebral body preoperatively by computer-planned path with intraoperative visualization endoscopy, minimizing the damage to spinal stability. Computer-assisted navigation with visualization endoscopy provides a more precise and minimally invasive approach to the treatment of osteoid osteoma of the spine.
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  • 文章类型: Case Reports
    未经证实:骨母细胞瘤在口腔颌面部区域相当罕见,而下颌骨总是好受的。然而,在我们的案例中,病变位于左侧颞叶关节结节,涉及邻近的颅底,这在文献中极为罕见。
    UNASSIGNED:在患者来我们科室之前,在当地医院被诊断为最常见的颞下颌关节紊乱病,主要是由于主要症状,那是,患者张口时左颞下颌关节区疼痛。然而,我们在MRI和锥形束CT中发现左侧颞骨结节有大量的骨病变,手术后证明是骨母细胞瘤。病人的主要症状在手术恢复后消失了,到目前为止还没有并发症或复发的迹象。
    UNASSIGNED:成骨细胞瘤在颞下颌关节区域非常罕见。在这种情况下,由于其不寻常的位置和令人困惑的主诉,它很容易错过良性肿瘤的可能性。我们的报告提供了在罕见部位鉴定成骨细胞瘤的经验。
    UNASSIGNED: Osteoblastoma is quite rare in the oromaxillo-facial region, while the mandible is always the predilection. However, in our case, the lesion was located in the left temporal articular tubercle, involving the adjacent skull base, which is extremely rare in the literature.
    UNASSIGNED: It had been diagnosed as the most common temporomandibular joint disorder in the local hospital before the patient came to our department, mainly due to the primary symptom, that was, the patient got pain in the left temporomandibular joint area while opening the mouth. However, we found a mass of bone lesions at the left temporal articular tubercle in MRI and cone beam CT, and it turned out to be an osteoblastoma after surgery. The patient\'s primary symptom disappeared after recovering from the surgery, and there have been no indications of complication or recurrence up to now.
    UNASSIGNED: Osteoblastoma is very rare in the temporomandibular joint region. It could easily miss the possibility of a benign tumor due to its unusual location and confusing chief complaint in this case. Our report provides experience in the identification of osteoblastoma in rare sites.
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  • 文章类型: Journal Article
    背景:刮除脊柱骨样骨瘤后的脊柱侧凸行为尚未明确,因为大多数关于骨样骨瘤(OO)继发脊柱侧凸的研究都是病例报告。这项研究的目的是调查(1)OO继发脊柱侧凸的临床和影像学特征;(2)OO刮除后的脊柱侧凸行为。
    方法:对1998年7月至2019年12月在单一机构中临床或病理诊断为OO的患者进行了回顾性研究。年龄,性别,疼痛的位置,术前收集病灶位置和脊柱侧凸曲线。术中失血,记录手术时间和手术并发症。术前、术后和末次随访时收集VAS评分和曲线大小。
    结果:平均手术时间为124±32分钟,平均术中出血量为274±134ml。术前平均VAS评分为6.2±2.7,术后平均VAS评分为2.1±1.8。术后胸椎侧凸由22.7±10.6°改善为6.2±4.3°,末次随访至4.1±4.3°。术后腰椎侧凸由18.1±7.4°改善为6.7±5.2°,末次随访至5.3±3.9°。术后躯干移位从34.7±12.4提高到10.5±7.2mm,末次随访时达到8.4±5.6mm。矢状面X线参数差异无统计学意义(P>0.05)。
    结论:脊柱OO患者脊柱侧凸的发生率明显较高。患者可以迅速缓解疼痛和脊柱侧弯,发生率低。夜痛,曲线凹侧疼痛,正常矢状位排列有助于将其与与腰椎间盘突出症相关的脊柱侧凸相鉴别。
    BACKGROUND: Scoliosis behavior after curettage of spinal osteoid osteoma has been not clarified as most studies regarding scoliosis secondary to osteoid osteoma (OO) were case reports. The aims of this study were to investigate (1) clinical and radiographic features of scoliosis secondary to OO; (2) scoliosis behavior after Curettage of OO.
    METHODS: A retrospective study was performed at patients who were diagnosed as OO clinically or pathologically from July 1998 to December 2019 in a single institution. Age, gender, location of pain, location of lesion and curve pattern of scoliosis were collected preoperatively. Intraoperative blood loss, operation time and surgical complications were documented. VAS scores and curve magnitude were collected pre- and postoperatively and at last follow-up.
    RESULTS: The mean operation time was 124 ± 32 min and the average intraoperative blood loss was 274 ± 134 ml. The mean preoperative VAS score was 6.2 ± 2.7, and the mean postoperative VAS score was 2.1 ± 1.8. Thoracic scoliosis was improved from 22.7 ± 10.6° to 6.2 ± 4.3° after operation, and to 4.1 ± 4.3° at last follow-up. Lumbar scoliosis was improved from 18.1 ± 7.4° to 6.7 ± 5.2° after operation, and to 5.3 ± 3.9° at last follow-up. Trunk shift was improved from 34.7 ± 12.4  to 10.5 ± 7.2 mm after operation, and to 8.4 ± 5.6 mm at last follow-up. There was no significant differences as to sagittal radiographic parameters (P > 0.05).
    CONCLUSIONS: Patients with spinal OO had a significantly high incidence of scoliosis. Patients could get rapid relief of pain and scoliosis with low occurrence. Night pain, pain at the concave side of curve, normal sagittal alignment could help differentiate it from scoliosis associated with lumbar disc herniation.
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  • 文章类型: Journal Article
    股骨近端骨样骨瘤(OO)极易误诊或漏诊。目的回顾性分析股骨近端OO患者的临床资料,以确定该病的临床表现和影像学特点,从而为股骨近端OO的术前诊断和临床治疗提供帮助。
    这是一项回顾性研究,涉及2015年1月至2021年1月我院收治的35例股骨近端OO患者。参与者的基线特征包括:24名男性和11名女性,年龄在13至25岁之间(平均16.2岁),病程1~14(平均6.3个月)。我们使用患者以前的医疗经验记录来分析误诊的原因。此外,我们比较了术前和术后治疗方法在减轻OO患者疼痛和恢复髋关节功能方面的差异。定期跟进,建议患者避免剧烈运动3个月。
    我们随访了35例患者(25例皮层间,4骨膜下,和6髓质)平均41.4个月。我们发现15例患者(42.9%)被误诊为滑膜炎,Perthes病,骨髓炎,关节内感染,关节结核和髋关节撞击综合征,从症状到诊断的平均时间为6.3个月。术后疼痛评分及关节功能评分较术前明显改善,并发症很少见。
    开放式手术切除通过准确而完全地去除病灶,构成了对股骨近端OO的有效治疗方法。考试选择错误,临床表现的复杂性和多样性构成了股骨近端OO误诊的主要原因。
    UNASSIGNED: Proximal femoral osteoid osteoma (OO) is extremely easy to be misdiagnosed or missed. The purpose of this study was to retrospectively analyze the clinical data of patients with proximal femoral OO in order to determine the clinical manifestation and imaging characteristics of the disease, so as to provide help for the preoperative diagnosis and clinical treatment of proximal femoral OO.
    UNASSIGNED: This was a retrospective study involving 35 patients with proximal femoral OO admitted into our hospital from January 2015 to January 2021. The baseline characteristics of the participants included; 24 males and 11 females, aged between 13 and 25 (mean 16.2) years old, and the course of the disease was 1 to 14 (mean 6.3) months. We used previous medical experience records of the patients to analyze for the causes of misdiagnosis. Moreover, we compared the difference between preoperative and postoperative treatment practices in alleviating pain in OO patients and restoring hip function. Follow-ups were carried out regularly, and patients advised to avoid strenuous exercises for 3 months.
    UNASSIGNED: We followed up 35 patients (25 intercortical, 4 sub-periosteal, and 6 medullary) for an average of 41.4 months. We found that 15 patients (42.9%) had been misdiagnosed of synovitis, perthes disease, osteomyelitis, intra-articular infection, joint tuberculosis and hip impingement syndrome, whose average time from symptoms to diagnosis were 6.3 months. Postoperative pain score and joint function score improved significantly compared with preoperative, and complications were rare.
    UNASSIGNED: Open surgical resection constitutes an effective treatment for proximal femoral OO by accurately and completely removing the nidus. Wrong choice of examination, and the complexity and diversity of clinical manifestations constitutes the main reasons for the misdiagnosis of proximal femoral OO.
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