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Eur Spine J (2013) 22:533541 DOI 10.1007/s00586-012-2566-7
ORIGINAL ARTICLE
Aneurysmal bone cyst of the mobile spine: the therapeutic role of embolization
L. Amendola L. Simonetti C. E. Simoes
S. Bandiera F. De Iure S. Boriani
Received: 30 May 2012 / Revised: 7 October 2012 / Accepted: 28 October 2012 / Published online: 8 November 2012 Springer-Verlag Berlin Heidelberg 2012
AbstractPurpose Our aim is to dene the role of embolization in the treatment of aneurysmal bone cyst of the spine in order to include this option in the decision making process. Methods From April 2004 to November 2009, seven patients with primary aneurysmal bone cyst of the mobile spine treated by embolization have been prospectively followed-up. All clinical presentations and imagings were recorded. There are many options of embolic agent and techniques used, but all aim to devascularize the tumor. The therapeutic protocol includes: embolization repeated every 8 weeks until the appearance of radiographic signs of healing. Complications, rate of healing and clinical outcome were analyzed.
Results The number of embolizations varied from one to a maximum of seven without related intra- or post-operative complications. One patient, after four selective arterial embolizations, underwent direct percutaneous injection of embolic agents into the cyst. A clinical and radiographical response was
achieved in all patients who were found alive and completely free of disease at mean follow-up of 46 months after last treatment and nobody crossed to surgical option. Conclusion Embolization seems to be the rst option for spinal aneurysmal bone cyst treatment because of the best cost-to-benet ratio. It is indicated in intact aneurysmal bone cyst, when diagnosis is certain, when technically feasible and safe and when no pathologic fracture or neurologic involvements are found. If embolization fails, other options for treatment would still be available.
Keywords Aneurysmal bone cyst Primary bone tumor
Mobile spine Embolization
Introduction
Aneurysmal bone cyst (ABC) is a benign cystic lesion of bone, composed of blood-lled spaces separated by connective tissue septa containing broblasts, osteoclast-type giant cells and reactive woven bone [1]. Its origin is unknown. It was rst described by Jaffe and Lichtenstein [2] in 1942, when it was differentiated from hemangiomas and other tumors with giant cells. It can occur as primary bone lesion (which consists of 70 % of the...