AB1021 Aneurysmal bone cysts of the spine: 4 case reports and review of literature

Abstract

BackgroundAneurysmal bone cysts (ABC) are rare, benign, highly vascular pseudotumors of unknown cause. It most often affects individuals during their second decade of life.ObjectivesOur goal was to document the clinical characteristics, diagnostic modalities and treatment results of ABCs.MethodsWe reviewed our institution’s database over a period of 15 years to identify patients diagnosed with aneurysmal bone cysts of the spine. Four patients underwent surgery in our department (2 men and 2 women). For those four patients, we tabulated the clinical characteristics, location, diagnostic modalities and treatment.ResultsThe clinical manifestations were gait disturbance in 2 patients and legpain in the other two. The tumour occurred in the dorsal spine in 2 cases and in the lumbar spine in the other two. All patients underwent surgical resection with total removal in only 2 patients. Postoperatively, clinical signs improved in all patients. Only one case presented tumour recurrence requiring second intervention and instrumentation.ABCs constitute approximately 1.5% of spinal bone tumours. They usually affect the posterior elements of the spine. MRI is the most useful modality for preoperative planning. It also helps to evaluate the fluidfluid level, which is characteristic for ABC on MRI. The differential diagnosis is mainly with giant cell tumours and osteoblastomas. The primary option for treatment is surgery. Instrumentation is sometimes necessary because of the increased risk of postoperative instability, especially in cervical spine surgery. The recurrence rate is 20% to 30% in case of incomplete resection.ConclusionsABCs are benign lesions. Surgical resection en bloc has the lowest recurrence rate. Instrumentation is sometimes necessary because of the increased risk of postoperative instability.References[1] Boriani S, De Iure F, Campanacci L, et al. (2001) Aneurysmal bone cyst of the mobile spine: report on 41 cases. Spine. 26:27–35[2] Pennekamp W, Peters S, Schinkel C, Kuhnen C, Nicolas V, Muhr G, Frangen TM (2008) Aneurysmal bone cyst of the cervical spine. Eur Radiol18:2356–2360[3] Sundaram M, McDonald DJ, Steigman CK, Bocchini T (1997) Metachronous multiple aneurysmal bone cysts. Skeletal Radiol26(9):564–567[4] Keenan S, Bui-Mansfield LT (2006) Musculoskeletal lesions with fluid–fluid level: a pictorial essay. J Comput Assist Tomogr30:517–524[5] Saccomanni R (2008) Aneurysmal bone cyst of spine: a review of literature. Arch Orthop Trauma Surg128:1145– 1147Disclosure of InterestNone declared