Complete resection, internal fixation and reconstruction for osteoblastoma of the cervical spine combined with torticollis：a follow-up report of eleven cases
KONG Jin-hai
XIAO Hui
SUN Zheng-wang
LIU Tie-long
QIAN Ming
LIN Zai-jun
WANG Ting
XIAO Jian-ru
Abstract：Objective To explore the clinical results of complete resection, internal fixation and reconstruction for osteoblastoma of the cervical spine combined with torticollis. Methods The clinical data of 11 patients with osteoblastoma of the cervical spine combined with torticollis who were adopted from February 2001 to November 2007 were retrospectively analyzed. There were 9 males and 2 females, whose average age was 20.6 years old ( range;9-33 years ). The cervical segments were involved, including C2 in 1 case, C3 in 1 case, C4 in 2 cases, C5 in 2 cases, C6 in 3 cases and C7 in 2 cases. All patients had both torticollis and cervical pain. The Cobb’s angle ranged from 20° to 39°, and the mean angle was 27.0°. Based on the American Spinal Injury Association ( ASIA ) impairment scale, there were 2 cases of grade A, 3 cases of grade B, 3 cases of grade C, 2 cases of grade D and 1 case of grade E before the operation. Resection through the posterior approach was performed on 7 patients and en-bloc resection through combined anterior-posterior approach was performed on 4 patients. All the patients underwent internal fixation and reconstruction. 1 patient embolization underwent preoperatively, and 2 patients radiotherapy underwent postoperatively. Results Tumor nests, sclerotic bone, peripheral tissues involved, swollen soft tissues and reaction zones were completely resected in all the patients. After the operation osteoblastoma was verified by pathology, including 2 cases of invasive osteoblastoma. The mean follow-up period was 85.6 months ( range; 60-126 months ). No recurrence was noticed after the operation. Cervical pain was obviously relieved at 5 years after the operation. The mean postoperative Cobb’s angle was 10.0° ( range;5°-15° ), which was decreased by 17o when compared with the preoperative angle. The differences between them were statistically signiifcant ( t=9.220, P<0.001 ).The postoperative ASIA impairment scale was increased by 1.82 grades on average ( t=5.590, P<0.001 ) when compared with the postoperative scale. No wound infection, poor healing or worse neurological symptoms occurred to the patients after the operation. Fever was noticed in 2 patients and cerebrospinal lfuid leakage in 1 patient, who all recovered after the indwelling time was prolonged. One patient had neck soreness and numbness, who got better after receiving physiotherapy. The screw loosening occurred to 1 patient at 3 year after the operation, who had the internal ifxator removed and then began to wear a brace for 1 year. During the follow-up, no serious cervical kyphosis or instability was found. Conclusions Complete resection, internal ifxation and reconstruction for osteoblastoma of the cervical spine combined with torticollis in adolescents can correct deformities of the cervical spine, relieve cervical pain, enhance the neurological function and improve the life quality of the patients.
Keywords：LaminectomyReconstructive surgical proceduresChondroblastomaInternal fixatorsTorticollisCervical vertebrae
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 341-345 )