Long-term follow-up of Ethibloc injection in aneurysmal bone cysts

Abstract

The aim of this study is to assess the long-term results of Ethibloc injection in aneurysmal bone cysts (ABC). Thirty-three patients with ABC were treated with computed tomography-guided percutaneous injection of Ethibloc into the cyst cavity. Twenty-two patients had Ethibloc injection as primary treatment and 11 patients had presented to us with recurrence after previous procedures including steroid injection, bone marrow injection, curettage bone grafting and various other surgical procedures. The mean follow-up was 54 (22-90) months. Symptoms were relieved in all patients. Two patients were lost to follow-up. Eighteen (58%) of the 31 patients followed, had complete resolution of the lesion, 11 (35.5%) patients had partial healing (asymptomatic residual nonprogressive lytic areas). Two (6.5%) patients showed recurrence in the proximal humerus during the follow-up. They are under follow-up but asymptomatic and another two patients encountered more significant complications after the procedure. Ethibloc injection is a relatively simple, minimally invasive alternative procedure for the treatment of ABC, and makes open operation unnecessary by stopping the expansion of the cyst and inducing endosteal new bone formation. This technique may be used as the primary management of ABC's excluding spinal lesions as shown by our largest and longest follow-up study.

An Uncommon Presentation of an Uncommon Bone Tumor: A Case Study of a Pathologic Fracture of an Intertrochanteric Aneurysmal Bone Cyst

“…Intralesional injections of calcitonin with steroids have proved to be safe and effective in regression of ABC lesions [16]. Doxycycline, Ethibloc® (Ethicon, Norderstedt, Germany), which is a mixture of zein, oleum papaveris and propylene glycol, and an aqueous solution of calcium sulfate have proved to be successful alternative treatments with low recurrence rates [17,18]. Radiotherapy is generally contraindicated secondary to adverse effects of radiation on growth plates and potential for future tumors.…”

Primary aneurysmal bone cysts in children: percutaneous sclerotherapy with absolute alcohol and proposal of a vascular classification

“…Osseous lesions in cervical vertebral bodies supplied by arterial branches of the vertebral arteries has also been described by Turowski et al [21]. A recent study of long-term followup of Ethibloc® injection concluded that the technique is minimally invasive and effective, but is not recommended for ABC of the spine [22]. Other techniques have been described for treatment of cervical ABC, such as percutaneous intra-lesional injection of calcitonin and methylprednisolone [23,24] or primary surgical management for deep lesions with extensive bone destruction [25].…”

Mid-term results of treatment with curettage and grafting in tumor-like cysts of long bones

“…In a study by Gibbs et al (32), the cortex was cleaned with a burr drill in addition to the curettage and bone grafting, and the recurrence rate was reported as 10%, and patients with open physes were reported as the greatest risk factor for this recurrence. George et al (33), who injected ethibloc into the cyst, published a successful long follow-up series with 58% complete recovery, 35.5% partial recovery, and 6.5% recurrence. In addition to the curettage and bone grafting, they also used argon beam coagulation as an adjuvant, and reported that they did not found any recurrence (34).…”