Aneurysmal bone cyst of the mobile spine: the therapeutic role of embolization

Amendola, Luca; Simonetti, L.; Simões, Christiano Esteves; Bandiera, Stefano; Iure, Federico De; Boriani, Stefano

doi:10.1007/s00586-012-2566-7

Cited by 98 publications

(75 citation statements)

References 26 publications

(36 reference statements)

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“…1,4,[15][16][17][18] Clinical experience with the embolization of these tumors is limited; however, several groups have reported beneficial effects from transarterial embolization as either a primary therapeutic modality or a preoperative adjunct technique. Preoperative transarterial embolization has been described to be a useful adjunct to surgical management of different other tumors such as osteoblastoma, [19][20][21] , angiolipoma, 22 hemangiopericytoma, 23 ganglioma, 24 paraganglioma, 25 angiosarcoma, 26 chordoma, 27,28 and giant cell tumors.…”

Section: Primary Spinal Tumorsmentioning

confidence: 98%

Preoperative embolization of hypervascular spinal tumors: current practice and center experience

Pikis

Itshayek

Barzilay

et al. 2014

Neurological Research

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Preoperative transarterial embolization of hypervascular spinal tumors has been extensively used, and is considered to be a highly effective adjuvant technique in reducing intraoperative blood loss during surgery. Moreover, it has been reported to increase the feasibility and safety of the surgical procedure, leading to better surgical outcomes. We review the English literature in an attempt to identify indications, appropriate timing of embolization in relation to surgery, technical aspects of the procedure, complications, and the contribution of embolization to the surgical management of spinal tumors. In addition, we report our experience with embolization of hypervascular metastases.

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Section: Primary Spinal Tumorsmentioning

confidence: 98%

Preoperative embolization of hypervascular spinal tumors: current practice and center experience

Pikis

Itshayek

Barzilay

et al. 2014

Neurological Research

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“…It may need to be repeated. It requires the presence of afferent vessels, and is not free of risk such as accidental ischemia of visceral organs or the spinal cord [25]. Preoperative embolization helps reduce risk of hemorrhage in ABC of the spine, sacrum or pelvis [10,22,24].…”

Section: Treatmentmentioning

confidence: 99%

Bone cysts: Unicameral and aneurysmal bone cyst

Mascard

Gomez‐Brouchet

Lambot

2015

Orthopaedics & Traumatology: Surgery & Research

231

280

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Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy.

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“…Complications occurred in 5 % of patients, which included skin necrosis and transient paresis [46]. High rates of local control have also been reported in treating spine ABCs [47,48]. Despite these results, SAE remains a limited treatment option, as lesions may lack identifiable feeding vessels or may be perfused by vessels that also feed nearby vital tissues and organs.…”

Section: Arterial Embolizationmentioning

confidence: 99%

Current management of aneurysmal bone cysts

Park

Yang

Sheppard

et al. 2016

Curr Rev Musculoskelet Med

184

259

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Aneurysmal bone cysts (ABCs) are benign bone lesions arising predominantly in the pediatric population that can cause local pain, swelling, and pathologic fracture. Primary lesions, which constitute roughly two thirds of all ABCs, are thought to be neoplastic in nature, with one third of ABCs arising secondary to other tumors. Diagnosis is made with various imaging modalities, which exhibit characteristic features such as Bfluid-fluid levels,^although biopsy is critical, as telangiectatic osteosarcoma cannot be excluded based on imaging alone. Currently, the standard of care and most widely employed treatment is intralesional curettage. However, tumor recurrence with curettage alone is common and has driven some to propose a multitude of adjuvants with varying efficacy and risk profiles. Historically, therapies such as en bloc resection or radiation therapy were utilized as an alternative to decrease the recurrence rate, but these therapies imposed high morbidity. As a result, modern techniques now seek to simultaneously reduce morbidity and recurrence, the pursuit of which has produced preliminary study into minimally invasive percutaneous treatments and medical management.

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Aneurysmal bone cyst of the mobile spine: the therapeutic role of embolization

Abstract: Purpose Our aim is to define 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

Cited by 98 publications

References 26 publications

Preoperative embolization of hypervascular spinal tumors: current practice and center experience

Preoperative embolization of hypervascular spinal tumors: current practice and center experience

Bone cysts: Unicameral and aneurysmal bone cyst

Current management of aneurysmal bone cysts

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