Secondary Deformities Research Articles

Exploring Self-Perception and Peer-Perception in Adolescents With Secondary Cleft Lip Deformities Using Eye-Tracking

Background: Patients with cleft lip often have a secondary cleft-lip deformity (SCLD), resulting from the initial repair procedure for their congenital cleft. Patients with SCLD often undergo multiple surgeries to achieve symmetry of the lip and nose. However, little is known about how patients perceive their deformity, and if those deformities are noticeable to their peers. The purpose of this study is to use eye-tracking to evaluate how patients with cleft lip repair look at themselves and evaluate how this perception changes when the same photo is perceived by 2 different cohorts: patients who have undergone cleft-lip surgeries and control subjects who have no craniofacial pathology. Methods: Participants were divided into 4 cohorts: adolescents with SCLD viewing images of themselves (Cohort 1), adolescents with SCLD viewing images of peers with SCLD (Cohort 2), adolescents without SCLD viewing images of peers with SCLD (Cohort 3), and healthy adolescents without SCLD viewing images of themselves (Cohort 4). Surveys were conducted after the eye-tracking portion to determine correlations between objective gaze data and subjective opinions. Results: Total fixation duration was highest in the eye region for all 3 cohorts, followed by the upper lip region. Cohort 2 fixated the longest on all areas of pathology, while Cohort 1 fixated the least on all areas of pathology. Cohort 4 spent significantly more time looking at the nose bridge compared to Cohort 1. Conclusions: The results provide insight into how adolescents with SCLD are perceived by themselves and others and can help to better understand the complexities of the roles different areas of pathology play in self-perception.

MODERN TECHNOLOGIES IN CLEFT RHINOPLASTY A LITERATURE REVIEW

This review article comprehensively analyzes contemporary methods in cleft rhinoplasty with secondary and residual deformities. The study encompasses the historical development of rhinoplasty, modern technologies, including trimming techniques and 3D printing, as well as challenges and prospects in this field. Clinical studies, ethical aspects, investigations of postoperative complications, and innovations in materials and biotechnology are considered in the context of optimizing outcomes in reconstructive rhinoplasty. The article's conclusion highlights key directions for future research, proposing a path toward improving practices and achieving optimal results in this medical specialty.

Novel classification system for adult Asian secondary bilateral cleft lip with nasal deformity that guides surgical strategy

BackgroundBilateral cleft lip is a congenital defect often accompanied by secondary lip and nose deformity. The current classification system for secondary cleft lip deformity of has limitations in guiding surgical planning. In this article, we report a method for secondary bilateral cleft lip classification that can guide surgery based on the pathological anatomy of the columellar and upper lip. MethodsPhotographs of patients were retrospectively classified into four types based on the ratio of columellar height to alar base width (CH/AW) and upper lip protrusion to lower lip (UP), as follows type I: with CH/AW ≥ 0.2 and UP ≥ 0; type II: with CH/AW ≥ 0.2 and UP < 0; type III: with CH/AW < 0.2 and UP ≥ 0; type IV: with CH/AW < 0.2 and UP < 0. Surgical treatments and the change of nasal profile were documented. ResultsA total of 105 patients from January 2008 to December 2018 were included in this study. The nasal profile was significantly improved in types III and IV patients with postoperative CH/AW values close to normal. The upper lip was distinctively retruded in type II and IV patients before treatment, and the postoperative view revealed improved upper lip protrusion with UP values close to normal. Ninety-eight patients reported satisfactory outcomes after treatment. ConclusionsThe new classification method described provides key information regarding the deformity of different types of secondary bilateral cleft lip patients and provides clear guidance for surgical planning based on the anatomical defect of each type.

Assessment of open rhinoplasty in correction of secondary nasal deformities associated with congenital anomalies in maxillofacial region

Purpose: Nasal deformities associated with cleft lip are one of the most difficult nose correction procedures. This study aims at correction of the nasal deformity that occurred after the initial repair of the lip, which was done at an early age, and achieving the best possible results aesthetically and functionally. Methods: The sample included patients presenting at the department of oral and maxillofacial surgery in Hospital between 2017-2018. We applied open rhinoplasty technique to correct nasal deformity according to a specific protocol. One year post operation, we analyzed clinical images before and after surgery and compared the results with the ideal normative values within society. Functional results were evaluated and the level of satisfaction of patients aesthetically was determined. Results: 10 patients aged between 16-35 years old were included in our study. The results showed improvement in the aesthetic aspect of the nose through the correction of the emergence and rotation of the tip of the nose. This technique did not significantly affect the functional results. Therefore the functional results were satisfactory. This technique has achieved good and satisfying results aesthetically and functionally. Conclusion: The data collected from this study demonstrates that open rhinoplasty technique in nasal deformities is effective in aesthetic improvement and it presents satisfactory results at the functional level.

ORBITAL WALL FRACTURE IN COMBINED INJURIES OF BONES OF THE FACIAL SKELETON

Combined injury of the maxillofacial region remains one of the topical problems of maxillofacial traumatology. Combined trauma to the maxillofacial region requires joint medical care by several specialists. Trauma of the upper and middle zones of the faceis often accompanied by trauma of the eye socket, paranasal sinuses. They are difficult to diagnose, in case of untimely diagnosis and rendered assistance lead to secondary defects and deformities. Damage to the walls of the orbit, leads to scarring changes in the fiber of the eye socket, eye muscles, persistent diplopia, ocular nerve impingement, persistent eye asymmetry, decreased or loss of vision is the cause of frequent disability.

Extended Superior Dermoglandular Pedicle Approach: A Versatile Technique for a Variety of Breast Deformities.

Although the selected pedicle is important in how it maintains nipple viability and is of equal importance, it can be utilized with the remaining breast tissue to reshape the breast mound. It is ideally used as an extended pedicle, as it allows us to use the tissue in the lower pole of the breast. The purpose of this article was to evaluate additional indications and outcomes using the extended superior pedicle approach along with conventional techniques. This is a retrospective study over 5 years of using an extended superior dermoglandular pedicle approach for managing a variety of breast deformities. Postoperative complications, along with patient and surgeon satisfaction, were assessed. All 68 patients expressed that the results were either excellent (85.3%) or very good (14.7%) according to the evaluation parameters. Among the 68 patients, there were 62 very good outcomes (91.2%) and six good outcomes (8.8%) according to surgeon evaluation. Only one reduction experienced a superficial partial loss, which was improved with no intervention. There was minor asymmetry in three patients (4.4%), which was not experienced by the patients, and poor scar quality in one dark-skinned patent. The author was able to expand the utility of extended superior pedicle for various breast deformities, such as reduction mammoplasty; mastopexy; augmentation mastopexy, either autoaugmentation or prosthetic; tuberous breast; after lumpectomy resection; and even in secondary breast deformities with reproducible and reliable outcomes across a wide patient population.

Nonossifying fibroma of the lower femur with genu valgum: a case report

BackgroundNonossifying fibroma is common in children and adolescents, and nonossifying fibroma with genu valgum is rare in the clinic. This article evaluated the effectiveness of treatment in a case of nonossifying fibroma of the lower femur with genu valgum.Case presentationA 16-year-old girl complained of pain in the lower part of her right thigh for one year. She was diagnosed as non ossifying fibroma of the right femur with secondary valgus deformity of the right knee, and was treated in our hospital. We performed curettage, bone grafting and internal fixation,and corrected the valgum deformity at the same time. The patient's incision healed well, the pain was disappeared, and the mechanical axis of lower limbs was corrected. No tumor recurrence was found on X- ray examination one year after operation, and the fracture end was healed. The patient could walk normally, and she was satisfied with her limb function.ConclusionNonossifying fibroma with genu valgum is rare in the clinic. The patient was satisfied with our treatment, which achieved a good curative effect.

Perception of aesthetic features after surgical treatment of craniofacial malformations by observers of the same age: An eye-tracking study

The aim of this study is to evaluate where exactly children and adolescents of the same group look when they interact with each other, and attempt to record and analyse the data recorded by eye-tracking technology. Materials and methods60 subjects participated in the study, evenly divided into three age categories of 20 each in pre-school/primary school age (5–9 years), early adolescence (10–14 years) and late adolescence/transition to adulthood (15–19 years). Age groups were matched and categorized to be used both for creating the picture series and testing. Photographs of patients with both unilateral and bilateral cleft lip and palate were used to create the series of images which consisted of a total of 15 photos, 5 of which were photos of patients with surgically treated cleft deformity and 10 control photos with healthy faces, that were presented in random order. Using the eye-tracking module, the data on "area of first view" (area of initial attention), "area with longest view" (area of sustained attention), "time until view in this area" (time of initial attention) and "frequency of view in each area" (time of sustained attention) were calculated. ResultsAcross all groups, there was no significant difference for the individual regions for the parameters of initial attention (area of first view), while the time until first fixation of one of the AOIs (time until view in this area) was significant for all facial regions. A predictable path of the facial scan is abandoned when secondary facial deformities are present and attention is focused more on the region of an existing deformity, which are the nose and mouth regions. ConclusionsThere are significant differences in both male and female participants' viewing of faces with and without secondary cleft deformity. While in the age group of the younger test persons it was still the mouth region that received special attention from the male viewers, this shifted in the male test persons of the middle age group to the nose region, which was fixed significantly more often and faster. In the female participants, the mouth and nose regions were each looked at for twice as long compared to the healthy faces, making both the mouth and the nose region are in the focus of observation.

Septal Extension Graft in Cleft Rhinoplasty: Patients with Secondary Unilateral Cleft Lip Nasal Deformity.

Tip refinement procedures are still controversial in secondary unilateral cleft rhinoplasty. The aim of this study was to assess whether the septal extension graft improved nasal and tip deformity and achieved a normal profile with clinical and three-dimensional morphometric analyses. A consecutive series of 194 skeletally mature patients with unilateral cleft were included and analyzed. All had undergone secondary open rhinoplasty, performed by a single surgeon, with the use of the septal extension graft between 2013 and 2021. Clinical data were collected, and three-dimensional morphometric measurements were performed. An age-, sex-, and ethnicity-matched normal group was included for comparisons. The authors' standard procedures included open approach combining reverse-U incision, septal extension graft, dorsal augmentation, lip revision, and vermilion augmentation. The postoperative outcome showed significantly increased numerical values (nasal bridge length, nasal height, nasal tip projection, nasal dorsum angle, columellar angle, columellar-lobule angle, nostril height ratio, nasal surface area, nasal volume) and decreased numerical values (alar width, tip/middle deviation, nasal tip angle, labial-columellar angle) compared with the preoperative morphology. The postoperative measurement showed significantly higher numerical values (nasal protrusion, tip/middle deviation, nasal dorsum angle) and lower numerical values (columellar-lobule angle, nostril height ratio, alar width ratio) compared with the control group. This study revealed that the authors' secondary cleft rhinoplasty significantly improved the underprojected, up-rotated, deviated, and poorly defined tip and short nasal bridge deformities. The technique could result in the nose of the patients with cleft lip nasal deformity being closer to that of the normative profile. Therapeutic, IV.

One-year clinical observation of muscular force balance reconstruction technique for the correction of secondary nasal malformation after cleft lip surgery.

The long-term effect of muscular force balance reconstruction technique combined with intranasal fixation for correcting secondary nasolabial deformity after unilateral cleft lip was evaluated. The aim was to provide a basis for further improving the surgical treatment effect of secondary nasolabial deformity of acleft lip. A total of 40 patients aged 4-28 years with secondary nasal deformity and unilateral cleft lip were selected as research subjects. The two-dimensional photo measurement analysis method was used in comparing the surgical results before and immediately after the operation (7 d) and 1 year after the operation. Columellar angle, nostril height ratio (NHR), alar rim angle, alar rim angle ratio, and nostril shape (NS) increased dimmediately after the operation, whereas alar base width ratio (ABWR) and nostril width ratio decreased (NHR) immediately after the operation (P<0.01). The ABWR, NHR, and NS immediately after the operation were not significantly different from those 1 year after the operation (P>0.05). Muscular force balance reconstruction technique combined with intranasal fixation is effective in the repair of unilateral secondary nasolabial deformity, and stable results can be obtained 1 year after surgery.

Management of the Middle Vault.

Early reductive rhinoplasty techniques focused on hump reduction and tip plasty with minimal focus on treating or preserving the integrity and width of the middle vault. With time, rhinoplasty surgeons noted the aesthetic and functional complications of the deformities that may occur in the middle vault with reduction techniques and developed methods to treat and also avoid these complications. Thus, the importance of protecting the integrity of the middle third of the nose has been increasingly emphasized over the years. Primary deformities of the middle vault that result in nasal obstruction require attention of the rhinoplasty surgeon, as well as preservation of support structures of the middle vault and internal nasal valve to minimize secondary deformities and functional compromise after rhinoplasty surgery.

Approach to nail trauma for primary care physicians.

To provide an overview and approach to common nail bed injuries seen by primary care practitioners. An Ovid MEDLINE literature search was performed using search terms and studies were graded based on level of evidence. Nail trauma is common in primary care practice and requires proper and prompt treatment to avoid lasting effects on finger function and cosmesis. When presented with a fingernail injury, primary care physicians should perform a thorough physical examination to determine extent of injury; take a history to rule out notable risk factors; perform a comprehensive neurovascular examination to assess pulp capillary refill, to do a 2-point discrimination, and to compare with an uninjured digit; and evaluate range of motion. Clinical evaluation may require local anesthesia and a tourniquet. Nail bed trauma can present in different ways and includes subungual hematomas, distal phalanx fractures, Seymour fractures, and-in more severe cases-fragmentation or avulsion of the nail bed. Treatment for subungual hematomas where the nail plate is intact does not require nail plate removal and nail bed exploration; however, exploration and repair are indicated for a nail plate injury, a proximal fracture involving the germinal matrix, and a distal phalanx fracture requiring stabilization. Fingertips are essential to normal hand function. Nail trauma is common and can be managed by primary care physicians. Shared decision making concerning management is based on the mechanism and extent of the injury and aims to prevent secondary deformities.

Establishment of a Three-Dimensional Finite Element Model and Mechanical Analysis of the Upper Lip Flap With Secondary Cleft Lip Deformity.

Cleft lip secondary deformity is a common oral and maxillofacial deformity, usually accompanied by the upper lip and nasal cleft. The main treatment method for cleft lip secondary deformity is surgical repair. Among them, upper lip flap repair is a common method; the principle is to transplant the healthy tissue to the lesion site to achieve the purpose of repair. However, during the surgical process, each key point's stress distribution and strain conditions are quite different. Therefore, special attention should be paid to the mechanical properties of each key point during the repair operation to ensure the surgical effect. This paper aims to establish a 3-dimensional finite element model and perform finite element analysis to simulate the mechanical properties and key point displacement of the upper lip flap repair operation for cleft lip secondary deformity to improve the operation's success rate and safety.

Success and Complication Rates of Different Techniques and Materials Used for Nasal Dorsal Augmentation in Rhinoplasty

Abstract Background Autologous materials, homograft and alloplastic implants are commonly used in nasal dorsal augmentation. So far, there is no satisfactory evidence to ascertain the safest, efficient, and superior in aesthetic outcomes among different materials. Thus, we aimed to conduct a systematic review and metaanalysis (SR, MA) of published literature to review rates of outcomes and complications of different materials used for nasal dorsal augmentation, in trial for better future surgical results. Methods Thirteen electronic databases were searched from inception through December 2018 and a manual search in October 2019. Results A total of 280 eligible studies were included, of which 165 articles were included in the meta-analysis. Compared to others, alloplastic expanded polytetrafluoroethylene (alloplastic e-PTFE) was considered first place, for having the highest graft scores in most of its outcomes; secondary deformity, resorption, patients’ satisfaction, displacement, extrusion, seroma, graft deviation, swelling, and hematoma outcomes with rates of (2%, 0.6%, 96.5%, 1.3%, 1.2%, 1%, 1%, 0.8%, 0.8%)respectively. Alloplastic silicone came after e-PTFE, for its superior results in revision rhinoplasty, success rate, aesthetic function, and scarring outcomes (4.1%, 99.9%, 98.8%, 2.7%) respectively. Autologous bone graft came at the last place as it had the least graft scores in patients’ satisfaction, displacement, perforation, and hematoma outcomes (50.7%, 9.3%, 8.3%, 5.4%)respectively. Autologous diced cartilage was superior in those outcomes; edema, bruising, and donor site complications (7.1%, 7.4%, 4.4%) respectively. Autologous costal cartilage had the highest graft scores in necrosis and graft exposure outcomes (4.3% and 1.9%), while it had the lowest graft scores in warping and success rate (7.1% and 87.3%). Autologous auricular cartilage had the highest graft scores in warping and foreign body reaction outcomes (1.4% and 6.3%), while it had the lowest graft scores in nasal obstruction and donor site complications rate (72.7% and 33.3%). Infection was the most common reported complication in MA, where autologous alar cartilage had the lowest infection rate of 0.2%, unlike alloplastic Medpor recorded the highest risk of 6.6%. Conclusions Regarding our results, we concluded that alloplastic e-PTFE yielded superior position in comparison to other materials, that would succeed as an alternative to convential autologous grafts, as had superior results in most of nasal dorsal augmentation outcomes. On the other hand, autologous bone graft was in the last place in all its outcomes. Future studies are needed to improve reporting of races variety, follow-up times, and diverse participants, as to resolve uncertainty regarding the ideal material for dorsal augmentation in rhinoplasty, with concentrating on proper assessment of races variety, which will improve selecting the proper graft implant.

Three-dimensional reconstruction reveals the correlation between the extent of alveolar clefts and secondary nasal deformity in adults.

This study aimed to explore the relationship between alveolar cleft and secondary nasal deformity post unilateral cleft lip repair in adults. A total of 27 patients aged 16-30 years old with unilateral secondary nasal deformity and alveolar cleft were included, 13 of whom underwent bone grafting. Spiral CT data of all preoperative and postoperative patients who had alveolar bone grafting were collected. Then, Mimics software was used for three-dimensional reconstruction to evaluate the correlation between the width, height, and volume of the alveolar cleft and those of the nasal deformity. The difference in nasal deformity before and after alveolar bone grafting was also explored. The width of the alveolar cleft was positively correlated with the difference in bilateral nostril floor width (P<0.05). As the effective depth of the alveolar cleft increased, the sub-alare inclination angle largened (P<0.05). However, no significant difference was found in the nasal deformity between before and after alveolar bone grafting. Alveolar cleft is closely related to secondary nasal deformities post unilateral cleft lip repair, especially nasal floor deformities. Alveolar bone grafting benefits adult patients for the improvement of secondary nasal deformities post unilateral cleft lip repair.

Treatment of dentofacial deformities secondary to condylar hyperplasia.

Dentofacial deformities secondary to condylar hyperplasiais a kind of disease presenting facial asymmetry, malocclusion, temporomandibular joint dysfunction, and other symptoms caused by non-neoplastic hyperplasia of the condyle. The etiology is still unknown, and currently, pre- and post-operative orthodontics accompanied by orthognathic surgery, temporomandibular joint surgery and jawbone contouring surgery are the main treatment methods. A personalized treatment plan was developed, considering the active degree of condyle hyperplasia, the severity of the jaw deformity, and the patient's will, to correct deformity, obtain ideal occlusal relationship, and regain good temporomandibular joint function. Combined with the author's clinical experience, the etiology, clinical and imageological features, treatment aims, and surgical methods of condylar hyperplasia and secondary dentofacial deformities were discussed in this paper.

Long-Term Nasolabial Appearance Post-Unilateral Cleft Lip Repair in a Single Center: A Descriptive Study.

Introduction Modern treatments still aim to keep the impact of surgical intervention low and the outcome of surgeries as good as a surgeon can. Assessing the long-term nasolabial appearance of patients who underwent cleft lip (CL) repair surgery is one of the methods of evaluating the outcomes of cleft surgery. Methods This is a retrospective cross-sectional descriptive study of data records of unilateral CL patients. The data records of all patients who underwent unilateral CL repair by the reconstructive science unit at Hospital Universiti Sains Malaysia (HUSM) within the first two years of their lives and whose current age is 14 years or above were accessed and analyzed. Results The data records of 50 patients were analyzed, including 13 (26%)males and 37 (74%) females. The surgeons opined that 28% of the patients had an acceptable nasolabial appearance, while there were 10 (20%)patients whose nasolabial appearance was considered unacceptable by the reviewing surgeons. Fifteen (30%)patients were described as having an acceptable lip appearance with secondary nasal deformity, and 11 (22%)patients had an acceptable nasal appearance with secondary lip deformity. There were no surgical modifications or postoperative complications among the patients. None of our variables reported a significant association with long-term nasolabial appearance. Conclusion The long-term evaluation of the nasolabial appearance in individuals with CL following surgical correction significantly improves the service and care provided to patients to achieve optimum results. Although our results showed no relationship between gender, age at operation, type or diagnosis of cleft, and family history and long-term nasolabial appearance, frequent assessments will enhance surgical results.

Correction of Cleft Lip Nose Deformity With Circular Shape Alar Graft and Block Costal Cartilage.

Secondary deformities of the cleft lip and nose are mainly caused by the long period of craniofacial development and the secondary scarring. Correction of the secondary cleft lip-nose deformity is a complex process that requires both the correction of the soft tissue and skeletal support. The purpose of this study was to present our experience in correcting the secondary unilateral cleft lip-nose deformities with autologous costal cartilage. A retrospective analysis of patients who underwent correction of unilateral cleft nasal deformity with simultaneous rhinoplasty by a senior surgeon from January 2015 to January 2022 was conducted. Preoperative and postoperative measurements of the columellar-labial angle and the inclination of nasal base were conducted to evaluate the surgical outcomes. A total of 54 patients were included in this study according to the inclusion criteria. The mean follow-up period was 4 years (range, 1-7 years). The mean values of the columellar-labial angle were 91.1 ± 9.2 degrees preoperatively and 101.0 ± 5.9 degrees postoperatively. The mean values of the inclination of nasal base were 4.5 ± 1.2 degrees preoperatively and 0.9 ± 0.4 degrees postoperatively. There was a considerable increase in the columellar-labial angle after the surgery (9.9 ± 6.0 degrees; P < 0.01). The inclination of nasal base decreased significantly (3.6 ± 1.1 degrees; P < 0.01). Our approach on correction the secondary clef lip nose through repositioning the muscles by Z-plasty and application of the block cartilage graft and circular shape alar graft has achieved long-term satisfactory results.

Aesthetic evaluation of nasolabial reconstruction using abbe flap in bilateral cleft lip patients with secondary deformities

The Abbe flap is a common technique frequently utilized in secondary surgery for bilateral cleft lip deformities, but objective indications for the Abbe flap remain unclear, and postoperative aesthetic evaluations are limited. The study group consisted of 92 bilateral cleft lip patients with secondary deformities aged 7-39 years, and the control group consisted of 33 people aged 19-35 years. Thirteen objective nasolabial aesthetic parameters were selected to evaluate patients' nasolabial aesthetics. Minor secondary deformities were characterized by a smaller lip height index than severe deformities, as well as a smaller columellar angle compared with moderate and severe deformities (P<0.05). For all patients, significant differences were found between preoperative and postoperative values of intercanthal distance/medial upper vermilion height ratio, intercanthal distance/medial upper lip height ratio, lip height index, lip vermilion height index, lip protrusion angle, columellar-labial angle, and nasal tip angle (P<0.05). For patients with minor deformity, intercanthal distance/philtrum width ratio and intercanthal distance/medial cutaneous upper lip height ratio showed no significant change postoperatively (P>0.05), and labial protrusion angle was smaller than the control group (P<0.05). Patients undergoing secondary surgery using an Abbe flap achieved good nasolabial aesthetics. Intercanthal distance/medial upper vermilion height ratio, intercanthal distance/medial upper lip height ratio, lip height index, columellar-labial angle, nasolabial angle, nasal tip angle, and columellar angle are the objective aesthetic indicators for Abbe flap selection. Intercanthal distance/philtrum width ratio, intercanthal distance/medial cutaneous upper lip height ratio, and labial protrusion angle are reference parameters for choosing an Abbe flap for secondary bilateral cleft lip revision.

Хирургическое лечение аневризмальных костных кист поясничного отдела позвоночника: описание клинического случая

Introduction Pediatric and adolescent patients with aneurysmal bone cyst of the spine are normally treated by orthopaedic, neuro surgeons and oncologists. There is no consensus on the strategy and volume of preoperative and surgical treatment of the condition. There is a higher risk of pathological fracture and secondary neurological complications, tumor recurrence if open surgery is not performed in time. A second surgical intervention can hardly be avoided in such cases. The objective was to report the result of surgical treatment of a patient with aneurysmal bone cyst of the spine. Material and methods Outcome of a patient with an aneurysmal bone cyst of the L3 vertebra is presented. The technique of using therapeutic punctures as a preoperative preparation to be followed by an open surgical treatment is described. Absence of complaints and tumor recurrence, stability of the metal construct and bone fusion were the evaluation criteria. Results The patient was followed for 17 months after open surgery and CT scans showed no recurrence and demonstrated bone fusion at a long term. Discussion Many aspects of the course of the disease are to be considered in the treatment of children and adolescents with aneurysmal bone cyst of the spine. In our opinion, the step in the treatment of aneurysmal bone cyst of the spine should be considered Puncture for therapeutic and diagnostic purposes is to be performed to reduce pathological process is reduced, and the procedure to be followed by surgical intervention to remove the tumor. The strategy of surgical treatment would rely on impaired supporting columns of the spine, the degree of neural structure compression and a secondary spinal deformity. The need and extent of metal fixation is to be evaluated, potential vertebral growth identified, expediency of bone grafting after tumor removal, radical excision of the pathological focus to be considered. Conclusion The clinical case showed an effective combination of surgical techniques in the treatment of an aneurysmal bone cyst of the spine. Preoperative therapeutic puncture of the cyst allowed for reduction of the pathological process (decreasing pressure inside the cyst, thickening the cortical layer of the cyst and delimiting the tumor from the surrounding tissues), decreased volume of surgical intervention and blood loss due to a decreased activity of the pathological process compared to cases of untimely performed open surgery. Metal fixation in combination with bone auto- and allograft was practical for bone fusion.