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首页> 美国卫生研究院文献>European Spine Journal >C2/C3 pathologic fractures from polyostotic fibrous dysplasia of the cervical spine treated with percutaneous vertebroplasty
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C2/C3 pathologic fractures from polyostotic fibrous dysplasia of the cervical spine treated with percutaneous vertebroplasty

机译：经皮椎体成形术治疗颈椎多发性骨增生性纤维异常增生的C2 / C3病理性骨折

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We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of patients with severe fibrous dysplasia of the spine with multiple cervical lesions and C2–C3 pathologic fractures that may not be a good surgical candidate. Polyostotic fibrous dysplasia involvement of the cervical spine is rare. Review of literature indicates only few reported cases of surgical management with one case of mortality indicating increased risks associated with surgical intervention. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization for fibrous dysplasia has not been reported. A 35-year-old man with McCune–Albright syndrome and severe polyostotic fibrous dysplasia of C2 and C3 vertebrae presented with severe neck pain, radiculopathy, quadriparesis and myelopathy. The lesion had pathologic fractures, and there was an os odontoideum with cervical cord atrophy at the C1 level. After discussing need for aggressive surgical management and potential complications, we offered PVP due to surgical risks involved. PVP was performed with a posterolateral transpedicular approach without complication. The patient had remarkable improvement in clinical relief of neck pain and improvement of myelopathic symptoms at 1-year follow-up. We present a case that illustrates a potential use of PVP in the management of a patient with symptomatic spinal fibrous dysplasia with associated pathologic fractures who was poor surgical candidate.
机译：我们将讨论经皮椎体成形术（PVP）在严重脊柱纤维异常增生，多发性颈椎病和C2–C3病理性骨折的患者的治疗中的潜在作用，这些手术可能不是好的手术治疗方法。颈椎多发性纤维异常增生受累。文献回顾表明，仅有少数报道的外科手术病例，其中一例死亡表明与外科手术有关的风险增加。尽管PVP通常用于治疗骨质疏松性胸腰椎椎体压缩性骨折，但尚未报道其在椎骨稳定中用于纤维异常增生的作用。一名35岁的患有McCune–Albright综合征和严重的多骨性C2和C3椎骨纤维发育不良的男子表现为严重的颈部疼痛，神经根病，四肢瘫痪和脊髓病。病变具有病理性骨折，在C1级存在一个具有牙髓萎缩的十二指肠。在讨论了积极的外科治疗和潜在并发症的需求后，由于涉及手术风险，我们提供了PVP。 PVP采用后外侧经蒂入路进行，无并发症。在1年的随访中，该患者的颈部疼痛临床缓解和骨髓病症状得到了明显改善。我们介绍了一个病例，该病例说明了在有症状的脊椎纤维性异型增生伴有相关病理性骨折的患者中，PVP的潜在治疗方法是较差的外科手术候选人。

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