Management Of Aneurysmal Bone Cyst Research Articles

Using Denosumab as a Nonsurgical Management of Aneurysmal Bone Cysts in the Pelvis.

Aneurysmal bone cysts (ABCs) are infrequent, benign, and locally destructive lesions that most commonly occur during the first two decades of life. They usually affect the metaphysis of the long bones, but the pelvis is involved in 8%-12% of the cases. The management of pelvic ABCs is a challenging issue due to difficulties in choosing the appropriate approach, adjacent neurovascular bundles, the risk of intraoperative bleeding with difficulty achieving good hemostasis, and the risk of injury to the hip or sacroiliac joints. Limited data exist concerning the use of denosumab as a non-surgical treatment for pelvic ABCs. Our hypothesis was that denosumab might be an effective and safe solo treatment of cases with ABCs in the pelvis. We retrospectively assessed 20 patients with ABCs in the pelvis, who were treated by denosumab as a solo agent without surgery. Patients were assessed regarding disease control, the incidence of recurrence and non-oncological complications, and functional outcome. The mean follow-up period was 38.5 months. Disease control was achieved in 16 patients (80%), with no local recurrence. Tolerable drug-related complications occurred in 15% of cases. The mean Musculoskeletal Tumor Society score was 92.3%. Denosumab may provide a reliable option in the nonsurgical treatment of ABCs of pelvic origin with expected lower morbidity than the surgical solution and tolerable complications. Further studies on the safety profile and long-term effects of denosumab especially in skeletally immature patients are required.

Role of Denosumab in the Management of Aneurysmal Bone Cysts

Background The management of aneurysmal bone cysts (ABCs) has evolved and less invasive methods have been tried. Denosumab is a monoclonal antibody that inhibits osteoclasts. It is effective in giant cell tumours of bone (GCT) and based on the immunohistochemical similarity and relationship between GCTs and ABCs, Denosumab may also be effective in the treatment of ABCs. Aim of the Work This study aims to assess the therapeutic importance, effectiveness and side effects of denosumab administration in the management of aneurysmal bone cysts. Materials and Methods Embase, Cochrane Library, and MEDLINE/PubMed databases were searched for the articles published from Jan. 2013 to May 2021 that reported the efficacy and safety of denosumab in patients with aneurysmal bone cysts (ABCs). Results Thirteen studies were reviewed, involving a total of 40 patients who had aneurysmal bone cysts and were treated with denosumab. Of the 13 studies, 82.5% of the patients were from case series studies (33 patients) and 17.5% were from case reports (7 patients). The clinical response rate for denosumab as a treatment for aneurysmal bone cysts was 94.7%, with statistical significance (P < .0001). No treatment-related deaths occurred in the reviewed studies. Conclusion We conclude that denosumab represents an effective treatment option for patients with ABC especially when high surgical morbidity is expected. Although denosumab therapy is associated with minimal complications, however, relapse following cessation of treatment is still possible. Finally, denosumab is a potentially safe and promising modality for medically managing ABCs that requires further investigation with prospective clinical trials.

Management of advanced metacarpal aneurysmal cysts: Surgical technique

The hand is a rare site for aneurysmal bone cysts (ABCs). Depending on their degree of invasiveness, treatment of ABCs ranges from medical therapy to surgical curettage and bone filling. In the most advanced cases, bone resection and reconstruction, with or without adjuvant or neoadjuvant treatment, are indicated.We describe a technique involving segmental bone resection and structural iliac graft reconstruction with carpo-metacarpal plate arthrodesis, for the management of advanced ABC involving the base of the metacarpals. The radio-clinical results of two patients operated on using this technique are presented, at 18 and 36 months.At the last follow-up, the results showed a QDASH of 15 and 10, and a PRWE of 9 and 11. Satisfaction was 10/10 in both cases. Grasp strength was 25 kg and 42 kg versus 28 kg and 40 kg on the opposite side. Pinch strength was 6 kg and 11 kg versus 7 kg and 10 kg. Metacarpophalangeal flexion was 80° and 90°. Extension was complete in both cases. Radiographs showed good graft fusion, with no lysis or signs of ABC recurrence at the last follow-up.Segmental bone resection and iliac autograft reconstruction with carpo-metacarpal plate arthrodesis represents a therapeutic option in the management of advanced ABCs of the metacarpal base.

The Role of Preoperative Embolization in the Management of Aneurysmal Bone Cyst: A Comparative Analysis.

The aim of this study was to evaluate the role of preoperative embolization in the management of aneurysmal bone cysts. In this study, the data of a total of 19 patients, 11 females and 8 males, with a mean age of 19.6 (range 5-46years), who were operated on in our hospital with the diagnosis of ABC between January 2015 and January 2021 were retrospectively analyzed. In the specified date range, there were 10 patients with a diagnosis of ABC who were operated on within 48h after preoperative embolization. For statistical comparison, 9 patients who were operated on without embolization in the same date range were included as the control group. The mean age of the study group was 16.7 (between 5 and 27years), while the mean age of the control group was 22.6 (between 16 and 46years). In the embolization group (group I), the mean intraoperative blood loss was 550mL (100-1200mL), the mean intraoperative blood transfusion was 270mL (0-900mL), and the mean surgical time was 85min. In the non-embolization group (group II), the mean intraoperative blood loss was 1250mL (600-2200mL), the mean intraoperative blood transfusion was 450mL (450-1800mL), and the mean surgical time was 90min. In comparison, a statistically significant difference was found between the embolization group and the non-embolization group in terms of blood loss and blood transfusion requirement (p = 0.011 and p = 0.017, respectively). The mean surgery time was slightly shorter in the embolized group, and there was no significant difference in surgical time between the two groups (p = 0.821). Evidence suggests that preoperative embolization of an aneurysmal bone cyst, performed 0-48h before surgery, can result in a reduction in intraoperative blood loss and intraoperative blood transfusion volume.

The ABCs of Aneurysmal Bone Cysts: Is there a Role for Radiation Therapy?

Aneurysmal bone cyst (ABC) is a rare osteolytic lesion which, though benign, can have devastating effects on the patient’s function and cosmesis. Surgery is the mainstay of treatment; however, for incompletely resected, inoperable, or recurrent ABCs, radiation therapy has been posited to be a feasible therapeutic modality. However, evidence on the possible role of radiation therapy in the management of ABCs remains in its infancy. This short review discusses what is currently known about the pathophysiology, natural history, epidemiology, and clinical presentation of ABCs. This will ultimately lead to a survey of the present literature on radiation therapy as used for ABCs.

Case report: denosumab in the management of aneurysmal bone cyst of the sacrum

Case report: denosumab in the management of aneurysmal bone cyst of the sacrum

Denosumab in the management of Aneurysmal bone cyst.

Aneurysmal bone cyst (ABC) is a benign, locally aggressive tumour that arises predominantly in long bones and spine. Following the encouraging results of denosumab use in Giant Cell Tumors (GCT) and the histological similarities between ABC and GCT, the interest on the role of denosumab in the therapeutic arsenal of the most advanced ABC is growing. The purpose of this literature review is to investigate the current state of knowledge about the use of denosumab in ABCs. A literature research was conducted through PUBMED, COCHRANE and GOOGLE SCHOLAR using the keywords "aneurysmal bone cyst" AND "denosumab". Seventeen articles were included. A total of 43 cases were reported in the literature. There were 23 males, 20 females. The mean age was 15,9±8,1 year. Pain relief and neurological improvement were rapid and sustained. Radiological assessment showed ossification and/or volume reduction in 36/39 patients. Eight patients (18,6%) presented a recurrence after or during denosumab therapy of whom 7 were adults. Adverse events occurred in 11 patients, 5 of them were admitted to the intensive care unit due to hypercalcemia. Denosumab use in non-surgical ABCs has shown a positive impact in pain and neurological symptoms. The oncological outcome remains unclear with a recurrence rate of 18,6% during/after denosumab therapy, mostly in adults. However, regarding the potential clinical benefits, its use might be discussed in the most advanced cases. Further research and clinical trials are mandatory to precise its belonging in the therapeutic arsenal.

Autologous mesenchymal stem cells in the treatment of spinal aneurysmal bone cyst

PurposeWe retrospectively analyzed a cohort of patients treated at our Centre with bone marrow concentrated (BMC) injection for aneurysmal bone cyst (ABC) of the spine, in order to propose this treatment as a valid alternative for the management of ABCs. MethodsFourteen patients (6 male, 8 female) were treated between June 2014 to December 2019 with BMC injection for ABC of the spine. The mean age was 15.5 years. The mean follow up was 37.4 months (range 12–60 months). The dimension of the cyst and the degree of ossification were measured by Computed Tomography (CT) scans before the treatment and during follow-up visits. ResultsSix patients received a single dose of BMC, five patients received two doses and in three patients three doses of BMC were administered. The mean ossification of the cyst (expressed in Hounsfield units) increased statistically from 43.48 ± 2.36 HU to 161.71 ± 23.48 HU during follow-up time and the ossification was associated to an improvement of the clinical outcomes. The mean ossification over time was significantly higher in patients treated with a single injection compared to patients treated with multiple injections. No significant difference in ossification was found between cervical and non-cervical localization of the cyst. Moreover, the initial size of the cyst was not statistically associated with the degree of ossification during follow-up ConclusionsResults of this paper reinforce our previous evidence on the use of BMC as a valid alternative for spinal ABC management when SAE treatment is contraindicated or ineffective.

Recent Trends in the Management of Aneurysmal Bone Cyst

Abstract Background Aneurysmal bone cysts (ABCs), were first described by Drs. Jaffe and Lichenstein in 1942 when they described pelvic and spine lesions that when exposing the lesion and opening in to its thin wall, the surgeon was immediately confronted by a large hole containing much fluid blood. Aim of the Work To describe the efficacy of new line treatment modalities of (Aneurysmal Bone Cysts) compared to conventional lines of management regarding the: • Long term outcomes and healing rate. • Recurrence rates. • Complications after therapy. Patients and Methods Criteria for considering studies for this review: • Types of the studies: published observational analytical studies (case-control_ case-series _ RCT or cohort studies) which studied the efficiency of new lines in the management of aneurysmal bone cyst. • Types of participants: participants were children and young age (below the age of 50 yrs) with a diagnosis of aneurysmal bone cyst. • Types of interventions: drugs like (Bisphosphonate or denosumab) were administered for a time determined by the case improvement, or minimally invasive techniques like (cryosurgery or curopsy) was done. Results Through the results of our study that compared between these recent modalities according to healing, recurrence, and complications rate; we are able to say that recent strategies have a high rate of healing ranges from 78.57% with bisphosphonate to 100% with doxycycline and cryotherapy. Conclusion There are recent evolving trends in the management of ABC other than the classic ways of management, they are less invasive, have less recurrence rate reaches to 0 % like with bisphosphonate, less complications rate as well reaches to 0 % like with doxycycline and bisphosphonate, high healing rate reaches to 100 % like with doxycycline and taking in consideration how to handle cases of ABC that classic way of management can’t handle like spinal ABC.

Aneurysmal bone cyst in the proximal femur: Combined approach of management: a case report

Purpose of Study: To study the effectiveness of combined extended curettage and sclerosant therapy in the management of aneurysmal bone cyst of proximal femur. Materials and Methods: A 22 years old male presented with complaints of left hip pain since 20 days, was examined clinically and radiologically. On MRI, he was diagnosed to have a non-expansile lytic lesion in the left proximal femur with features suggestive of aneurysmal bone cyst or an unicameral bone cyst. Patient was planned and taken up for aspiration and curettage followed by a single sitting sclerosant therapy with 3% polidocanol, bone cementing combined with plating. Curetted sample was sent for histo-pathological examination. Patient was advised restricted weight bearing for a period of 4 weeks. Regular follow-ups of the patient was done at 1, 3, 12 and 18 months post-operatively to assess for recurrence. Results: Histo-pathological examination confirmed the diagnosis of aneurysmal bone cyst. With regular follow-ups, patient had a good functional outcome and no evidence of recurrence with this technique at 18 months follow-up. Conclusion: Aneurysmal bone cyst has a higher recurrence rate with curettage and bone grafting alone. Extended curettage along with sclerotherapy with 3% polidocanol has shown no evidence of recurrence at 18 months follow-up in our study. Hence, this combined approach can be recommended in the management of aneurysmal bone cyst.

Role of intralesional polidocanol in management of Aneurysmal bone cyst.

Background: Aneurysmal bone cyst is a true benign bone tumor often seen in young children and adolescents. ABCs often present with impending or pathological fracture due its aggressive cortical erosion. Modalities of treatment viz: Curettage with or without graft, Enbloc excision, cryotherapy, argon beam laser, radiotherapy, arterial embolization are often associated high morbidity & high complication rates. Objectives: The aim of this study was to evaluate the clinical & radiological efficacy of polidocanol in the management of Aneurysmal bone cyst. Material & Methods: After radiological and cytological confirmation of ABC, 18 patients meeting the inclusion criteria were included in this study. The patients were treated with intralesional polidocanol under fluoroscopic guidance. Results: The mean age of patients was 8.2 years. Mean number of injections required was 3.2, with three patients showing radiological resolution after single injection. Recurrence was seen in 1 patient after showing initial resolution. There were no cases of anaphylaxis or local inflammatory reactions. Conclusion: Polidocanol is a safe and inexpensive alternative to other modalities of treatment and should always be first line of treatment for the management of the Aneurysmal bone cyst.

Surgical management of aneurysmal bone cyst of fibular head with en bloc excision: A case report

Aneurysmal bone cysts (ABCs) are benign but locally destructive, blood filled reactive lesions of the bone. Although a wider age group may be affected, most commonly they are seen in patients younger than 20 years of age, with a slight female preponderance. Most common sites include metaphysis of femur followed by tibia and then humerus. Vertebral lesions involving the posterior elements are common. Aneurysmal bone cyst of proximal fibula is a rare and uncommon. Here, we report a case of 32 year old male with classic histologic, clinical, and radiographic findings that was treated by en bloc resection.

Management of aneurysmal bone cyst of proximal femur with a pathologic intertrochanteric femur fracture with an intramedullary nail and bone graft: A case report

Aneurysmal bone cyst (ABC) is a benign tumor like lesion that is an expanding osteolytic lesion consisting of blood-filled spaces of variable size separated by connective tissue septa containing trabeculae or osteoid tissue and osteoclast giant cells. Nearly 95% occur in the first three decades. Aneurysmal bone cysts are benign active or aggressive bone lesions that commonly arise in the metaphysis of long bones, especially the femur, tibia and humerus. They are extremely rare, occurring in 1.5 per one million people per year. And usually present with pain, swelling or fracture. We report a case of a giant aneurysmal bone cyst in the proximal femur with a pathologic Inter-trochentric femur fracture in a 23 year old male patient which was treated with a proximal femur nail and curettage and bone grafting of the lesion in the proximal femur. At 18 months follow-up, the lesion had subsided and patient was walking pain-free with full range of motion without any deformity. We suggest this method of treatment to be worthwhile for a pathologic fracture of an ABC at proximal femur.

Denosumab Therapy in the Management of Aneurysmal Bone Cysts: A Comprehensive Literature Review.

Aneurysmal bone cysts (ABCs) are uncommon lesions that involve the axial and appendicular bones. Although biologically benign, ABCs have the tendency to assume an aggressive behavior causing local destruction of the underlying bone and neighboring soft tissues. Morphologically, ABCs are composed of cyst-like cavities filled with blood and bounded by an array of diverse cells including fibroblasts, inflammatory infiltrates and osteoclast-like multinucleated giant cells. From a molecular perspective, the osteoclast-like multinucleated giant cells harbor high expression of receptor activator of nuclear factor kappa B (RANK) receptors, whereas the neoplastic stromal cells harbor high expression of RANK ligand (RANKL). The RANK-RANKL interaction has been implicated in the carcinogenesis of ABCs and giant cell tumor of bones (GCTBs). Currently, the optimal management of ABCs remains a hotly debated topic. There are a multitude of treatment modalities (that is, surgery, sclerotherapy, radiotherapy and selective arterial embolization), and each modality has its own benefits, morbidity and risk of complications. The local aggressiveness of ABC and its high rates of relapse following treatment has demanded the march towards discovering more innovative therapies. One of such therapies is denosumab, a monoclonal antibody targeted against the RANKL. Denosumab is already approved by the United States Food and Drug Administration (FDA) for the treatment of adults and skeletally mature adolescents with GCTB that is unamenable to surgery, or initial surgery is anticipated to result in significant morbidity. However, denosumab is not approved by the FDA for the management of ABCs. However, taking into consideration the morphological similarity between GCTBs and ABCs, some treating physicians have logically opted to use denosumab in an off-label manner to treat select ABCs. To the best of knowledge, no study has attempted to summarize the related literature on the use of denosumab in ABCs. Therefore, the primary aim of this study is to narratively review all the available literature about the efficacy and safety of the use of off-label denosumab in the management of patients with ABCs.

Review of 16 cases of aneurysmal bone cyst in the proximal femur treated by extended curettage and cryosurgery with reconstruction using autogenous nonvascularized fibula graft.

Aneurysmal bone cyst (ABC) is an aggressive benign lesion that may sometimes be difficult to treat. Lesions that occur in the proximal femur require to be addressed aggressively because of the high rate of local recurrence and the risk of fracture. Few articles report the experience of management of ABC in the proximal femur. This location presents a surgical challenge due to its anatomical and biomechanical peculiarity. We retrospectively reviewed 16 cases with ABC in the proximal femur that were treated in our institution between 2005 and 2014, utilizing extended curettage and liquid nitrogen as adjuvant therapy and reconstruction using nonvascularized autogenous fibular strut graft. The mean follow-up period was 50.5 months. Five cases presented as recurrent cases, while four cases presented with pathological fractures. The functional score ranged from 70 to 90 on modified Musculoskeletal Tumor Society score with a mean score of 81.25, which is considered to be excellent function. Time for graft incorporation ranged from 10 to 12 weeks. One case got local recurrence, and one case got early surgical site infection. Extended curettage and cryotherapy represent a recommended approach for management of ABC in the proximal femur with favorable results.

WITHDRAWN: Management of aneurysmal bone cyst using non-vascularised fibula graft – A series of four cases

Aneurysmal bone cyst (ABC) is an uncommon pathological condition, which leads to weakening and fracture of the affected part of the bone. Radiologically, ABC is an eccentric, metaphyseal, expansile, lytic and non-neoplastic lesion of the bone, giving blown-out/ballooned/soap-bubble appearance. Though benign, malignant transformation is reported. It accounts for 1–6% of all primary bone tumours with incidence rate of 0.14% annually. Usually occurs during second decade of life and most common sites for the lesions are the tibia, femur, vertebra, pelvis, humerus and fibula. The various treatment modalities include selective arterial embolisation, en-bloc/wide marginal resection and curettage with phenol, liquid nitrogen, etc., use of sclerosing agents and use of autogenic/allogenic bone graft or polymethylmethacrylate, with or without osteosynthesis. There exists controversy regarding optimum treatment of ABC as recurrence rate ranges from 5–40% depending upon the treatment method used. Use of non-vascularised fibular strut graft yields good results as per many studies especially in large lesions. Hereby, we present four cases of ABC, treated by extended curettage or En bloc excision of lesions and reconstruction using fibular strut graft.

Results of cement augmentation and curettage in aneurysmal bone cyst of spine.

Aneurysmal bone cyst (ABC) is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal pedicle has an important role in surgery aimed for curettage of vertebra.

Aneurysmal Bone Cysts of the Hand, Wrist, and Forearm

To determine the outcomes of surgical management of aneurysmal bone cysts (ABCs) in the hand, wrist, and forearm. The medical records of 11 patients undergoing surgical treatment of ABCs distal to the elbow from 1994 to 2011 with at least 12 months follow-up were reviewed retrospectively. Mean follow-up was 29 months (range, 13-56 months). There were 7 males and 4 females. Four lesions presented in the radius, 3 in the ulna, 2 in the metacarpals, and 2 in the phalanges. Ten patients underwent wide unroofing and intralesional curettage with 9 undergoing associated high-speed burring. Multiple chemical and thermal adjuvants were used. One patient underwent en bloc resection with reconstruction. There was 1 recurrence in a periphyseal lesion in a 2-year-old boy treated with curettage, burring, and adjuvant chemotherapy. Ten patients incorporated the bone graft and healed without further surgery. One patient required revision bone grafting. The diagnosis of ABC should remain in the differential diagnosis for cystic lesions in the upper extremity in pediatric and adult patients. Low recurrence has been obtained predominantly with intralesional curettage and high-speed burring with and without chemical and thermal adjuvant therapy. Appropriate healing has been obtained with both allograft and autograft reconstructions. Periarticular and periphyseal lesions remain challenging and provide the highest chance for incomplete resection and recurrence. Follow-up with plain radiographs did not lead to any delay in diagnosis of recurrence in any case.

3:30 PM Abstract No. 52 - Outcome of endovascular treatment for aneurysmal bone cysts

Purpose Surgical management of aneurysmal bone cysts (ABCs) is associated with perioperative morbidity, mortality and high recurrence. In addition, some ABCs are inoperable. We evaluated the presentation, morphology, technique and outcome of percutaneous image guided sclerotherapy for ABCs. Materials and Methods We retrospectively reviewed the medical records and imaging studies of patients with ABCs who underwent percutaneous sclerotherapy at our institution. Age, location, size, symptoms, image guidance, agents used and outcomes were documented. Symptomatic and radiological changes were evaluated and compared pre and post sclerotherapy. Results 27 pts (5-18 yrs; mean age, 11.5 yrs) including 20 nonspinal ABCs (5-18 yrs; mean age, 11.5 years) and 7 spinal ABCs (8-18 yrs; mean age, 13 yrs) underwent percutaneous sclerotherapy. Most common symptoms were pain, swelling and neurological. 21 pts had biopsy proven ABCs. Sonographic, fluoroscopic or C-arm flat-detector CT (dynaCT) as well as combinations of these modalities was used for guidance. The sclerosant agents were sodium tetradecyl sulfate (n=23), ethanol (n=12) and doxycycline (n=8); either singly or in combinations. In 7 pts (4 nonspinal, 3 spinal) sclerotherapy was combined with transarterial embolization.1-9 sclerotherapy sessions were performed (mean: 5). Range of follow-up was 2-69 (mean, 35.5) months. In 17 (85%) nonspinal and 4 (71%) spinal lesions, pain resolved, completely in 16 pts (14 nonspinal and 2 spinal) and partially in 10 pts (5 non-spinal and 5-spinal). Radiological regression was noted in 14 (70%) nonspinal and 3 (43%) spinal lesions. 3 other pts with spinal ABCs showed radiological progression and spinal instability. 6 pts (5 spinal, 1 nonspinal) required further operative interventions but with significantly lesser blood loss. There were no complications related to sclerotherapy. Conclusion Endovascular treatment is a safe and effective treatment for aneurysmal bone cysts. It can be used as definitive treatment or as a bridge to elective surgical operation. This approach provides symptomatic relief and regression of the size of most ABCs, with more favorable outcome in nonspinal lesions.

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

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)