Technetium-99 m-MDP scintigraphy and long-term follow-up of musculo-skeletal sarcoma reconstructed with pasteurized autologous bone graft
Technetium-99 m-MDP scintigraphy and long-term follow-up of musculo-skeletal sarcoma reconstructed with pasteurized autologous bone graft
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DOI：
10.1007/s00402-008-0659-x
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发表时间：
2009-04-01
影响因子：
2.3
通讯作者：
Ahmed, Adel Refaat
中科院分区：
文献类型：
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作者：
Ahmed, Adel Refaat
局部骨肿瘤切除，然后巴氏消毒和再植是一种独特的技术重建肉瘤患者。回顾性回顾了巴氏消毒骨移植物的长期显像结果与临床患者数据的关系。2000年4月至2004年1月间22例肉瘤患者（平均年龄24岁）构成了本研究的材料。回顾了152个99米tc -二膦酸亚甲基（MDP）全身扫描。最初，所有的自体移植物都出现光子缺乏区域。术后4-6个月内截骨部位骨摄取弥漫性增加，17例患者术后约6个月检测到移植物巴氏消毒骨的摄取。22例患者中，11例（50%）摄取高于正常骨，6例（27%）摄取与正常骨相似，5例（23%）摄取低于正常骨。影像学上，15例（68%）患者表现为移植物完全融合，5例（23%）患者表现为部分融合。肿瘤方面，16例患者无病，6例死于疾病。平均59个月未发现局部复发，骨折（13.6%）最终通过植骨和翻修内固定愈合，移植物塌陷（9%）（需要翻修关节置换术）和感染（9%）是主要并发症，1例治愈，1例转为旋转成形术。当示踪剂摄取提示血运重建时，机械并发症明显增加；因此，血运重建和部分骨长入不是降低机械并发症发生率的充分条件。骨巴氏灭菌法是恶性骨肿瘤切除后重建的有效选择。
Local bone tumor excision followed by pasteurization and reimplantation is a unique technique of reconstruction for sarcoma patients. The long-term scintigraphic findings of pasteurized bone grafts in relation to clinical patients' data were reviewed retrospectively.Twenty-two sarcoma patients (mean age, 24 years) done between April 2000 and January 2004 constituted the material of this study. One hundred and fifty-two 99 m TC-methylene diphosphonate (MDP) whole-body scans were reviewed. Initially, all autografts appeared as photon deficient areas. Diffusely increased bone uptake was present at the osteotomy sites within 4-6 months after surgery, the uptake of the grafted pasteurized bone was detected in 17 patients from about 6 months after surgery.Of 22 patients, 11 (50%) showed higher uptake than the normal bone, 6 (27%) had uptake similar to the normal bone, while 5 (23%) had less uptake than the normal bone. Radiologically, 15 patients (68%) showed complete incorporation of graft and 5 patients (23%) had partial incorporation. Oncologically, 16 patients are disease free, while 6 died of disease. No local recurrence was detected at a mean of 59 months, while fracture (13.6%) eventually healed with bone grafting and revision of internal fixation, graft collapse (9%) (needed revision arthroplasty) and infection (9%), one cured and one converted to rotationplasty, were the major complications encountered. Significantly more mechanical complications were seen when tracer uptake suggestive of revascularization occurred; thus, revascularization and partial bone ingrowth are not sufficient conditions for lower mechanical complication rate.The method of pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors.