Surgical Resection of Aneurysmal Bone Cyst of the Spine

Introduction: It is estimated that 11 - 24% of aneurysmal bone cysts localize in the spine. Local recurrence following surgical treatment has been reported to range between 20 - 70% in different series. We report our experience in the surgical management of these lesions of the spine. There were 12 patients; 7 males and 5 females. Age at time of surgery ranged between 4 and 18 years. All patients presented with axial pain, and 7 (58%) with radicular pain. Four (33%) patients had a neurological deficit, four (33%) presented with spinal deformity and three (25%) had a palpable mass. Nine (75%) patients had previous surgeries (a total of 17 operations).

Method: Complete intralesional surgical resection was performed in all patients. No adjuvant therapy was performed in this series. Resection required sequential anterior and posterior surgery in 9 patients and posterior surgery only in three. Spinal reconstruction and stabilization was performed with a variety of methods depending upon the location of the lesion, its extent within the spine and the age of the patient.

Results: Follow up period ranged 28 - 63 months. All patients reported improvement in their axial and radicular pain, three (75%) of those with a preoperative neurological deficit showed neurological recovery and one patient remained unchanged. At their latest follow-up, all patients showed evidence of radiological fusion, with no local recurrence detected.

Conclusion: Total intralesional resection of ABC lesions of the spine is successful in managing these oftenly aggressive lesions. This series demonstrates the success of surgery in eradicating these lesions when thorough and complete resection is performed.