Application of extensive curettage in the treatment of giant cell tumors of the spine：a clinical report of 18 cases

HAO Lin; SUN Yang; NIU Xiao-hui

doi:10.3969/j.issn.2095-252X.2015.08.007

Abstract：Objective To observe clinical effects of extensive curettage in the treatment of giant cell tumors of the spine.Methods From May 2006 to May 2012, 18 patients diagnosed as giant cell tumors of the spine were retrospectively analyzed, with complete clinicopathologic and follow-up data. There were 8 males and 10 females, with the mean age of 31.6 years old. All patients had preoperative pain symptoms of varying degrees, while 5 patients were combined with spinal cord involvement, 1 with cervical spine, 9 with thoracic spine, 8 with lumbar spine. All received extensive curettage, speciifcally, simple anterior approach in 10 patients, simple posterior approach in 3 patients, and combined anterior with posterior approach in 5 patients. Ten patients underwent postoperative adjuvant radiotherapy and the other 8 patients did not undergo radiotherapy, among which simple anterior approach in 6 patients, simple posterior approach in 1 patient, and combined anterior with posterior approach in 1 patient. Effects were observed in follow-up.Results The median follow-up time of 18 patients was 46 months ( range: 12-83 months ). There were 4 patients of relapsed ( 22.2% ). The average period of recurrence was 34.5 months ( range: 6-71 months ). They all underwent simply anterior approach without postoperative adjuvant radiotherapy. Wherein, 3 patients underwent extensive curettage and adjuvant radiotherapy again, and 1 patient underwent routine radiotherapy. Wherein, the average follow-up time of above 4 patients were 36 months after re-treatment ( range: 12-59 months ). There was no recurrence. Postoperative pain was disappeared in 11 patients and relieved in 7 patients. Involved functions of the spinal cord in 5 patients received different degrees of improvement. Pedicle screw was broken in 1 patient at 27 months postoperatively.Conclusions Extensive curettage is easier to operate. The local recurrence rate of extensive curettage with postoperative radiotherapy in the treatment of giant cell tumors of the spine is comparable with other methods.