背景:涉及脊柱的单骨纤维发育不良(MFD)很少见,治疗方案是有争议的。当患者遭受持续性疼痛时需要手术,脊髓压迫/损伤,和椎骨塌陷/不稳定。治疗方法包括活检/观察,全身切除术与器械融合,后路融合,椎体成形术(VP),刮宫和植骨,并通过前后融合手术完全切除椎骨。
方法:患者是一名56岁的女性,有2年的颈部疼痛病史。在神经或体格检查中没有发现明显的异常,实验室检查结果均在正常范围内.影像学检查提示C7椎骨肿瘤。患者拒绝继续保守观察治疗,要求手术治疗。进行了C7椎体的开放VP,术后颈部疼痛完全缓解。术后病理结果支持诊断为纤维发育不良,患者最终被诊断为MFD。在为期12个月的随访中,患者报告没有临床症状,没有发现肿瘤复发的迹象。
结论:VP可以缓解疼痛,同时稳定脊柱。因此,通过VP手术治疗MFD椎体病变是一种有价值的选择。
BACKGROUND: Monostotic fibrous dysplasia (MFD) involving the spine is rare, and the treatment options are controversial. Surgery is needed when patients suffer from persistent pain, spinal cord compression/injury, and vertebral collapse/instability. Treatment methods include biopsy/observation, corpectomy with instrumented fusion, posterior fusion, vertebroplasty (VP), curettage and bone graft, and complete removal of the vertebra with a combined anterior and posterior fusion procedure.
METHODS: The patient was a 56-year-old woman with a 2-year history of neck pain. No obvious abnormalities were detected on neurological or physical examination, and laboratory findings were all within normal limits. An imaging examination suggested a C7 vertebral bone tumor. The patient refused to continue conservative observation treatment and requested surgery. Open VP of the C7 vertebral body was carried out, and her postoperative neck pain was completely relieved. The postoperative pathological results supported the diagnosis of fibrous dysplasia, and the patient was ultimately diagnosed with MFD. At the 12-month follow-up visit, the patient reported no clinical symptoms, and no signs of tumor recurrence were detected.
CONCLUSIONS: VP can relieve pain while stabilizing the spine. Thus, the surgical treatment of MFD vertebral lesions by VP is a valuable option.