Secondary aneurysmal bone cyst of the spine: Clinicopathological features, surgical modalities and outcomes

Abstract

ObjectivesSpinal secondary aneurysmal bone cyst (SABC) is extremely rare with few published reports available at present. Our aim is to explore the clinicopathologic features, surgical modalities and outcomes of spinal SABC. Patients and methodsA retrospective study of 33 patients with spinal SABC who were surgically treated in our center between 2010 and 2018 was performed. Clinical data, treatment options, complications and outcomes were analyzed. ResultsOf the 33 patients, 12 were male and 21 were female, with a mean age of 32 years. Eleven lesions were located at the lumbar spine. The underlying lesions included giant cell tumor (GCT) (n = 20), osteoblastoma (n = 7), hemangiaoma (n = 3), fibrous dysplasia (n = 2) and osteosarcoma (n = 1). Preoperative selective arterial embolization was applied in 24 patients. All the patients were treated surgically through either subtotal resection (n = 1), piecemeal total resection (n = 21), or total en bloc resection (n = 11). Four patients experienced recurrence and one patient died during the follow-up period. ConclusionSpinal SABC is popular in the third and fourth decade of life with female predominance. GCT is the most common underlying lesion. Preoperative arterial embolization is recommended, while surgery is the mainstay of treatment for spinal SABC. En bloc resection is recommended for spinal SABCs especially when underlying tumor is aggressive or malignant.