第8胸椎Osteoid Osteomaの1治験例—選択的脊髄血管撮影の診断的有用性について

A CASE OF OSTEOID OSTEOMA AFFECTING THE T8 NEURAL ARCH; WITH SPECIAL REFERENCE TO SELECTIVE SPINAL ANGIOGRAPHY

はじめに

　Osteoid osteomaは，全骨腫瘍の中で数％にも満たない稀な腫瘍である。その好発部位は，主に大腿骨・脛骨などで，脊椎に発生するものはさらに少ない。最近，我々は，第8胸椎の左laminaに原発したosteoid osteomaの症例を経験し，術前の選択的脊髄血管撮影にてtumorstainを得たので，その診断的意義と併せて報告する。

A Case of osteoid osteoma originating from the left lamina of the eighth thoracic vertebra was reported.

The patient was a 20-year-old female with the history of back pain and scoliosis of seven years duration. The neurological findings on admission were spastic paraplegia, anesthesia below T9 level, and neuralgia in T8 area. Plain film of thoracic spine showed the irregular osteosclerosis on the left side of T8 vertebra. Myelography revealed the complete block between T7 and T9. Selective spinal angiography in that the intercostal and lum-bar arteries were selectively catheterized, showed the doughnut-like tumor stain corresponding to the osteosclerosis of T8vertebra.

Laminectomy from T6 to T9 with subtotal remoral of the vascular bone tumor was done on March 26, 1971.

The histological examination revealed typical osteoid osteoma composed of osteoid nidus and surrounding reactive osteosclerosis.

Postoperative course was good, and she could walk with stick after two months.

Brief review of the literature was made, and the incidence, symptoms, roentgenological findings, and histological characteristics of osteoid osteoma were discussed.

The authors emphasized the importance of selec-tive spinal angiography for the more accurate diag-nosis of spinal cord diseases. The technique concern-ing seletive catheterization was described, and our experience of 25 cases were summarized.