良性原发性椎体肿瘤的治疗：WFNS脊柱委员会的建议

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-08-18 DOI:10.1016/j.inat.2025.102114

Francesco Costa , Francesco Restelli , Niccolò Innocenti , Corinna Zygourakis , Zan Chen , Mirza Pojskic , Onur Yaman , Artem Gushcha , Salman Sharif , Mehmet Zileli

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引用次数: 0

摘要

背景：良性原发性椎体肿瘤（pvt）代表了一组不同的脊柱病变，尽管它们是非恶性的，但可以显著影响患者的生活质量。本综述旨在就良性室性早搏的治疗策略提出最新的循证建议。方法在PubMed/EMBASE/MEDLINE数据库中进行综合检索。纳入标准包括2012年1月至2023年12月之间的英文出版物。筛选过程包括审查摘要，评估全文文章，以及审查额外研究的参考文献列表。采用入选标准以确保入选相关研究。数据提取涉及记录各种变量。共筛选了160篇摘要，最终选出99篇文章进行进一步审查。57篇符合纳入标准的文章被纳入本研究。结果在WFNS（世界神经外科学会联合会）脊柱委员会的两次共识会议上进行了讨论和投票，使用德尔菲法达成了肯定或否定的共识。结果MRI/CT成像对诊断和治疗方案至关重要，分类系统指导手术策略；一般情况、肿瘤组织学和预期寿命必须考虑在内。整体切除是恶性肿瘤的金标准，而根据病变类型，椎体成形术、放疗或微创消融可能是合适的。对于类骨骨瘤、成骨细胞瘤、abc、巨细胞瘤和血管瘤，我们提出了具体的治疗建议，包括栓塞、活检和新出现的经皮手术。结论WFNS脊柱委员会最终确定了多个关于良性原发性椎体肿瘤治疗的推荐指南。建议进一步进行高质量的研究，以建立更实质性的证据和建议。

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Management of benign primary vertebral tumors: WFNS spine committee recommendations

Background

Benign primary vertebral tumors (PVTs) represent a diverse group of spinal lesions that, despite their non-malignant nature, can significantly impact patients’ quality of life. This review aimed to formulate the most current, evidence-based recommendations regarding the management strategies for benign PVTs.

Methods

To this aim, comprehensive search was conducted in PubMed/EMBASE/MEDLINE databases. Inclusion criteria included English-language publications between January 2012 and December 2023. The screening process involved reviewing abstracts, assessing full-text articles, and reviewing reference lists for additional studies. Eligibility criteria were applied to ensure the selection of relevant studies. Data extraction involved recording various variables. A total of 160 abstracts were screened, resulting in 99 articles being selected for further review. 57 articles met the inclusion criteria and were included in the study. The results were discussed and voted in two consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee, reaching a positive or negative consensus using the Delphi method.

Results

Imaging with MRI/CT is essential for diagnosis and treatment planning, with classification systems guiding surgical strategies; general condition, tumor histology, and life expectancy must be considered. En-bloc resection is the gold standard for malignant tumors, while vertebroplasty, radiotherapy, or minimally invasive ablation may be appropriate depending on lesion type. Specific management recommendations were confirmed for osteoid osteoma, osteoblastoma, ABCs, giant cell tumors, and hemangiomas, including the role of embolization, biopsy, and emerging percutaneous procedures.

Conclusions

The WFNS Spine Committee finalized multiple recommendation guidelines on the management of benign primary vertebral tumors. Further higher-quality studies are recommended to establish more substantial evidence and recommendations.

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