目的:探讨寰枢椎骨样骨瘤的治疗方法及初步疗效。方法:回顾性分析我院2000年~2011年收治的5例寰枢椎骨样骨瘤患者,男3例,女2例,年龄6~22岁,平均12.2岁。患者均有颈痛,VAS评分7~8分,平均7.8分,夜间加重,口服非甾体抗炎药(NSAIDs)症状可缓解。均无神经损害体征,4例有斜颈畸形。核素骨扫描均显示寰枢椎代谢活跃灶;CT显示2例病灶位于寰椎侧块,3例位于齿状突,瘤巢最大直径为10~15mm,平均11.8mm。4例患者经NSAIDs药物治疗半年以上,1例患者疗效满意继续药物治疗;3例患者半年后颈痛复发,其中2例患者伴斜颈畸形,增加药物剂量及服药次数均不能有效缓解症状,行开窗瘤巢刮除、植骨融合术,手术入路分别为经口、右颌下及后路,术后继续NSAIDs治疗。另1例患者因继发寰枢关节脱位就诊,行后路复位枕颈内固定融合术,未切除肿瘤,术后接受NSAIDs治疗。结果:3例开窗瘤巢刮除手术平均耗时110min,平均出血量40ml,手术后病理证实为骨样骨瘤,术后患者均继续口服NSAIDs治疗,平均随访21.6个月,颈痛均缓解,VAS评分平均1.6分,斜颈得到纠正,无相关并发症;随访期间复查CT未见肿瘤复发或进展,其中1例患者术后继续药物治疗1年后停药,随访26个月症状无复发。2例保守治疗患者症状缓解满意,1例随访期间无进展,1例6个月时复查CT可见瘤巢硬化表现。结论:寰枢椎骨样骨瘤少见,NSAIDs治疗短期内疗效肯定,应首先考虑;对于药物疗效欠佳或出现继发损害的患者,应采取开窗瘤巢刮除植骨术,术后继续应用NSAIDs药物治疗可取得较好效果。 Objective: To investigate the treatment and primary efficacy of atlantoaxial osteoid osteoma. Methods: Five patients with atlantoaxial osteoid osteoma who were treated in our hospital from 2000 to 2011 were retrospectively analyzed. There were 3 males and 2 females, aged 6-22 years (average 12.2 years). Patients had neck pain, VAS score 7 to 8 points, an average of 7.8 points, increased night, oral NSAIDs symptoms can be alleviated. No signs of nerve damage, 4 cases of torticollis deformity. Radionuclide bone scan showed active atlantoaxial metabolism; CT showed two lesions located in atlas lateral mass, three cases located in the odontoid, neoplasm maximum diameter of 10 ~ 15mm, an average of 11.8mm. Four patients were treated with NSAIDs for more than half a year, and one patient was satisfied with the drug treatment. Three patients had neck pain recurrence six months later. Two of them had torticollis malformation, which could not relieve the symptoms effectively. Window neoplasm curettage, bone graft fusion, surgical approach were oral, right submandibular and posterior, after continuing NSAIDs treatment. Another patient was diagnosed with atlantoaxial dislocation secondary to posterior atlantoaxial fixation of the occipitocervical fistula. The tumor was not removed and received NSAIDs postoperatively. Results: Three cases of neoplasm removal surgery took an average of 110 minutes and the average amount of bleeding was 40 ml. The postoperative pathology was osteosarcoma. After operation, all patients continued oral NSAIDs treatment. The average follow-up was 21.6 months, and neck pain was relieved , VAS score average 1.6 points, torticollis was corrected, no relevant complications; no recurrence or progress of CT during the follow-up examination, of which 1 patient discontinued treatment after 1 year of drug treatment, follow-up of 26 months without recurrence of symptoms . 2 cases of conservative treatment of patients with symptoms were satisfactorily relieved, 1 case no progress during follow-up, 1 case of 6 months review of CT showed neoplasia. Conclusion: Atlantoaxial osteoid osteoma is rare, NSAIDs treatment of short-term efficacy is positive, should be considered first; for the poor efficacy of drugs or secondary damage in patients with nests should be taken to curettage and bone grafting, after continued application NSAIDs drug treatment can achieve better results.