Continuous decompression of unicameral bone cyst with cannulated screws: a comparative study

Abstract

We determined the role of mechanical decompression in the resolution of unicameral bone cyst. A total of 69 children with unicameral bone cysts were treated either by (i) open curettage and bone grafting, (ii) steroid injection or (iii) cannulated screw insertion. During a mean follow-up of 69 months (range, 12-58), the cysts were evaluated by radiological criteria. The healing rates in the three groups were 25, 12 and 29% after the first treatment, and a further 50, 19 and 65% after the second. The study has demonstrated the advantages of the decompression technique for unicameral bone cysts over other treatment modalities studied.

Injection of Demineralized Bone Matrix With Bone Marrow Concentrate Improves Healing in Unicameral Bone Cyst

“…Finally, we believe it important to improve the operative technique by opening of the medullary canal from the diaphyseal side to reduce the pressure inside the lesion. This has been attempted using medullary nails or cannulated screws [2,28]; however, in those series, the healing rate of the cyst was not sufficiently consistent because of the lack of osteogenic stimuli. When an adequate cyst opening procedure is associated with the bone formation enhancing agents such as BM and DBM, healing can be more consistent [18].…”

Unicameral Bone Cyst of the Scaphoid: A Report of Two Cases

“…22,23 The success rate of each method and the definition of success varies between studies. [24][25][26][27][28][29][30] Other treatments include intra-cystic injection of methylprednisolone acetate (to decrease the secretion of the synovial fluid and increase the rhythm of bone cell duplication), 23 mechanical disruption of the cyst lining and/or wall by curettage, structural support with flexible intramedullary nailing, 31 decompression with multiple drill holes 32 and cannulated screws, 33 and any combination of the above.…”

The Effect of Steroid in the Treatment of Simple Bone Cysts

“…The success rate was reported as 90-96% in studies which were done with steroid injection techniques in the 1970s and 1980s [13,14]. However in studies that were done in the 2000s, it was reported that the success rate of this technique was between 20% and 40% [20,25].…”

“…They achieved successful results in 16 (42%) of these patients. In a study done by Brecelj et al [21] in 2007, they treated 69 patients diagnosed with bone cyst with conventional surgery, cannulated screw and steroid injection technique. They reported that successful results were achieved in only 19% with steroid injection technique.…”

“…In this respect many modalities have been performed in the treatment of this lesion, but as yet without acceptable success. Among these treatment modalities there are mechanical treatments including curettage and grefonage [10][11][12], treatment methods with injection (steroids, bone marrow, demyelinalized bone matrix) [11,[13][14][15][16][17] decompression of cysts (multiple drilling, pin, nail and screw) [18][19][20], structural support and decompression (elastic intramedullary nail) [21][22][23][24]. The long-used and the most popular of these treatment modalities is the cortisone injection technique.…”