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目的 :总结 36例脊柱骨巨细胞瘤临床诊断和治疗的经验。方法 :36例脊柱骨巨细胞瘤 ,男性 19例 ,女性17例 ,年龄 12～ 6 7岁。颈椎 16例 ,胸椎 6例 ,腰椎 5例 ,颈胸段、胸腰段和骶骨各 3例。 1990年前的 10例中 3例颈椎骨巨细胞瘤单独应用放射治疗 ,余 7例用外科手术切除加放射治疗。 1991年以后 ,2 3例有CT和MRI扫描 ,故用Enneking外科分期 ,并结合Weinstein -Boriani-Biagni外科分期进行分类 ,SⅡ期 6例和SⅢ期 3例沿肿瘤假囊行椎体切除与脊柱内固定治疗 ,13例SⅢ期病例用全椎切除与脊柱内固定治疗。结果 :单独应用放射治疗的 3例颈椎骨巨细胞瘤和应用手术加放射治疗的 7例随访 7～ 30年 ,无肿瘤局部复发。椎体切除的 9例与全椎切除的13例 ,随访 2～ 8年 ,有 3例因切除不彻底复发 ,其余 19例到目前无局部复发。结论 :完全切除病损是控制脊柱骨巨细胞局部复发的有效措施。放射治疗是有益的辅助治疗方法
Objective: To summarize the clinical experience of 36 cases of giant cell tumor of the spine. Methods: Thirty-six cases of giant cell tumor of the spine were studied. There were 19 males and 17 females, aged 12 to 67 years old. 16 cases of cervical, 6 cases of thoracic, 5 cases of lumbar, neck thoracic, thoracolumbar and sacral in 3 cases. Three cases of cervical giant cell tumor of cervical spine were treated with radiotherapy alone in 10 cases before 1990, and the other seven cases were treated with surgical resection plus radiotherapy. After 1991, 23 cases had CT and MRI scans, so they were classified by Enneking surgical staging combined with Weinstein-Boriani-Biagni surgical staging. Six cases of SⅡ and 3 cases of SⅢ were treated with vertebral resection and spine Internal fixation treatment, 13 cases of S Ⅲ cases with total vertebral resection and spinal fixation. Results: Three cases of cervical giant cell tumor of cervical spine treated with radiotherapy alone and 7 cases treated with surgery plus radiotherapy were followed up for 7 to 30 years without local tumor recurrence. Vertebral resection in 9 cases and total vertebrectomy in 13 cases, followed up for 2 to 8 years, 3 cases due to incomplete removal of recurrence, the remaining 19 cases to the present no local recurrence. Conclusion: Complete resection of the lesion is an effective measure to control the local recurrence of giant cells in the spine. Radiation therapy is a useful adjunct to treatment