Complete Intra-Lesional Resection for Aneurysmal Bone Cyst of the Spine. A Personal Experience of 15 Consecutive Cases

Abstract

Background Data: Several methods of treatment have been reported for the management of aneurysmal bone cyst (ABC) of the spine. Incomplete excision has been associated with a high local recurrence rate. Purpose: To review a personal case series of fifteen cases of ABC of the spine treated by complete intralesional resection and to present the clinical and radiological results. Study Design: Retrospective review of the clinical and radiological data. Patients and Methods: Fifteen patients, 8 males and seven females with mean age of 12.7 years underwent complete intralesional resection of ABC lesions of the spine with reconstruction. All patients presented with local axial spine pain, 60% with radicular pain, 47% with a neurological deficit, 13% with painful scoliosis and 13% had a palpable mass. Thirty three percent had previous attempts at surgical resection. Results: Mean operative time was 6.4 hours and mean estimated blood loss was 1850ml. Mean follow up was 52.9 months. Eighty six percent of those with a preoperative neurological deficit showed a complete recovery. All patients obtained a solid fusion or were radiologically healed at final follow up (52.9 months).Conclusion: Complete intralesional excision of ABC lesions of the spine is an effective method of treatment. Attention to reconstruction of the spine is mandatory and should be individually tailored to each case. This surgical strategy eliminated local recurrence in this case series. (2012ESJ027)