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: 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 first option for spinal aneurysmal bone cyst treatment because of the best cost-to-benefit 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.
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: 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 first option for spinal aneurysmal bone cyst treatment because of the best cost-to-benefit 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.
Authors: Charles G Fisher; Christian P DiPaola; Timothy C Ryken; Mark H Bilsky; Christopher I Shaffrey; Sigurd H Berven; James S Harrop; Michael G Fehlings; Stefano Boriani; Dean Chou; Meic H Schmidt; David W Polly; Roberto Biagini; Shane Burch; Mark B Dekutoski; Aruna Ganju; Peter C Gerszten; Ziya L Gokaslan; Michael W Groff; Norbert J Liebsch; Ehud Mendel; Scott H Okuno; Shreyaskumar Patel; Laurence D Rhines; Peter S Rose; Daniel M Sciubba; Narayan Sundaresan; Katsuro Tomita; Peter P Varga; Luiz R Vialle; Frank D Vrionis; Yoshiya Yamada; Daryl R Fourney Journal: Spine (Phila Pa 1976) Date: 2010-10-15 Impact factor: 3.468
Authors: S Boriani; F De Iure; L Campanacci; A Gasbarrini; S Bandiera; R Biagini; F Bertoni; P Picci Journal: Spine (Phila Pa 1976) Date: 2001-01-01 Impact factor: 3.468
Authors: Gian L Natali; Guglielmo Paolantonio; Rodolfo Fruhwirth; Giuseppe Alvaro; George K Parapatt; Paolo Toma'; Massimo Rollo Journal: Br J Radiol Date: 2015-09-23 Impact factor: 3.039
Authors: Connie Y Chang; Susan V Kattapuram; Ambrose J Huang; F Joseph Simeone; Martin Torriani; Miriam A Bredella Journal: Skeletal Radiol Date: 2016-10-14 Impact factor: 2.199