Two-stage resection and spinal stabilization for aneurysmal bone cyst. A report of two cases.

Two cases of aneurysmal bone cyst of the dorsal lumbar spine are presented with four- and seven-year follow-up periods. The lesion in each case involved the vertebral bodies and posterior elements and extended to contiguous bony structures. Both anterior and posterior staged procedures were required for maximal excision, rendering the spine extremely unstable at the involved levels. Anterior strut grafting with autogenous iliac bone was done during the first stage after the vertebral bodies had been curetted. Three weeks later the remaining dorsal elements and associated tumor were removed through a posterior approach, and the spine was stabilized with the Harrington compression-distraction system and posterior autogenous iliac crest grafts. Both patients were neurologically normal after operation, and the spines in both were stable and solidly fused. Both have remained symptom-free and have had no evidence of recurrence.