CAJ | 학술논문

目的研究脊柱动脉瘤样骨囊肿(ABC)的临床特点,探讨外科手术治疗及其预后.方法对1996年至2006年接受手术治疗的12例活动节段脊柱的ABC患者的临床资料进行回顾性分析.依据肿瘤的WBB分期,实施全椎节切除7例,矢状切除1例,后弓切除4例.分别采用前后联合入路或后外侧入路行肿瘤切除、植骨或骨水泥椎体重建、椎弓根内固定术.术后对8例行放疗.结果术中平均出血量为3210 ml,随访10-116个月,平均41.8个月.7例脊髓神经功能完全恢复,4例术后1～2年局部复发,1例放疗后恶变成软骨肉瘤并多处转移后死亡.结论脊柱ABC临床较少见,常呈侵袭性生长易复发.术中尽量做到肉眼下彻底切除肿瘤,能有效改善神经症状并降低局部复发率.术后辅助局部放疗可降低复发率.
목적 연구척주동맥류양골낭종(ABC)적림상특점,탐토외과수술치료급기예후.방법 대1996년지2006년접수수술치료적12례활동절단척주적ABC환자적림상자료진행회고성분석.의거종류적WBB분기,실시전추절절제7례,시상절제1례,후궁절제4례.분별채용전후연합입로혹후외측입로행종류절제、식골혹골수니추체중건、추궁근내고정술.술후대8례행방료.결과 술중평균출혈량위3210 ml,수방10-116개월,평균41.8개월.7례척수신경공능완전회복,4례술후1～2년국부복발,1례방료후악변성연골육류병다처전이후사망.결론 척주ABC림상교소견,상정침습성생장역복발.술중진량주도육안하철저절제종류,능유효개선신경증상병강저국부복발솔.술후보조국부방료가강저복발솔.
Objective To investigate the effects of surgical treatment and prognosis of aneurysmal bone cyst(ABC)in mobile spine. Methods A total of 12 patients with ABC were operated on from 1996 to 2006, and the clinical data were retrospectively reviewed. The patients included 7 male and 5 female,aged from 16 to 52 years(mean,29 years). Surgical interventions were selected according to WBB criteria.Seven patients underwent total spondylectomy,four underwent resection of posterior arch,one patient received sagital resection only. Anti-poster or post-lateral approach reconstruction with bone-graft or bone cement and transpedicular screws fixation were performed in the cases. Eight cases received radiotherapy after the operation. Results The mean operation blood lose was 3210 ml. The patients were followed-up for 10 to 116 months(mean,41.8 months). Seven patients got complete recover of spinal cord function,4 patients experienced local recurrence in 1-2 years post operation. One patient died of multiple metastasis of chondrosacoma after radiotherapy. Conclusions ABC in spine is an aggressive disease with high local recurrence rate. Enbloc if possible provides the best result,with excellent prognosis. Radiotherapy should be selected carefully.