title: [Medical therapy of polyostotic fibrous dysplasia of the spinal column].
abstract: OBJECTIVE
  To discuss treatments of spinal polyostotic fibrous dysplasia (PFD) and their clinical outcomes.
  
  
  METHODS
  A group of spinal PFD patients treated in orthopaedic department of Peking University Third Hospital from January 2005 to December 2010 was retrospectively reviewed. There were 3 males and 1 female. The age was 53, 17, 32, 38 years, respectively. Two cases underwent preoperative CT-guided biopsy and the other two had previous pathologic results. All the patients complained localized pain and VAS (visual analogue scale) ranged from 3 to 5. All the cases had pathologic fractures and 3 cases had neurological impairment. The surgical procedures for each patient were as follows: lesion resection combined with cervicothoracic fixation and fusion; reduction combined with occipitocervical fixation and fusion; vertebroplasty (VP); VP combined with posterior decompression and fixation.
  
  
  RESULTS
  Fibrous dysplasia in each patient was confirmed by postoperative pathological examination. The operation time was 420, 150, 120, 300 minutes and blood loss was 3 400, 500, 200, 2 000 mL. The follow-up period was 84, 24, 34, 12 months. The primary symptoms were fully relieved without any surgery related complication. There was no symptom recurrence or lesion progress during the follow-up. No signs of radiological improvements (filling of lytic lesion, cortical thickening, or both) were detected.
  
  
  CONCLUSIONS
  Spinal PFD is a rare disease and mostly affects adults. Conventional excision therapy is an effective and reliable treatment for spinal PFD, but vertebroplasty is less invasive. VP alone might be more appropriate for patients complaining only pain symptoms and/or with pathologic fractures. VP combined with limited decompression and stabilization may be more suitable for patients with neurological deficits.
authors.affiliation: Department of Orthopaedic, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Feng-liang
authors.initials: FL
authors.lastname: Wu
authors.forename: Liang
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Pathological, Peking University School of Basic Medical Science, Beijing 100191, China.
authors.forename: Shao-min
authors.initials: SM
authors.lastname: Yang
authors.affiliation: Department of Radiology, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.forename: Xiao-guang
authors.initials: XG
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Wei
authors.forename: Miao
authors.initials: M
authors.lastname: Yu
authors.forename: Zhong-jun
authors.initials: ZJ
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005359:Fibrous Dysplasia, Polyostotic / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty