The preliminary clinical study of reservation vertebral osteoepiphysis during eosinophilic granuloma resection in children

English Keywords:Bone tumor  Spinal tumor  Osteoepiphysis  Eosinophilic granuloma

English Abstract:

  【Abstract】 Objectives: To discuss the effect of the development of eosinophilic granuloma(EG) resection by reserving vertebral osteoepiphysis in children. Methods: From January 2008 to December 2013, 6 EG patients including 5 males and 1 female aged 6-13(average 9.8±2.9) years were included in this series. The tumors were sited in thoracic spine(T8-9; T11; T11-12) in 3 cases and in lumbar spine(L2; L4; L5) in 3 cases. All the patients presented with the low back pain and serious night pain. The X-ray indicated that the vertebral bodies infiltrated more or less, and one patient had slight kyphosis in T11-12. All the patients underwent posterior operation(resection of the tumor through pedicle, reservation of vertebral osteoepiphysis, reconstruction of the spine stability by pedicle screws with slight distraction). After that, all the patients accepted Vincristine chemotherapy for 4 times. The pain level was evaluated before and 2 weeks after operation by VAS scores. Anterior body heights of the diseased vertebrae were recorded before and 1 year after operation, meanwhile the kyphosis was also observed. Results: 6 patients were followed up for 1-4 years, averaged 2.3 years. Recurrence and spine malformation were not found in all patients. The VAS scores decreased significantly(P<0.05), from 5.5±1.2(pre-operation) to 1.3±0.4(2 weeks post-operation). The height of the anterior body of diseased vertebrae increased significantly(P<0.05), from 0.4±0.1cm(pre-operation) to 1.1±0.2cm(one year after operation). The kyphosis angle decreased from 30°(pre-operation) to 20°(one-year after operation). Conclusions: EG resection while reservation of vertebral osteoepiphysis in children was effective and safe, which can reach the best spine profile, but not intervene the growth and development of spine to the great extend.