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Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management
AIM: To review the published literature on the treatment of aneurysmal bone cysts (ABCs). METHOD: A systematic review of the English literature to April 2019 for all articles, with a minimum of three patients and 2-year follow-up, reporting on the treatment of spinal ABCs. The various treatment opti...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817493/ https://www.ncbi.nlm.nih.gov/pubmed/31695521 http://dx.doi.org/10.2147/ORR.S211834 |
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author | Parker, Jack Soltani, Sherry Boissiere, Louis Obeid, Ibrahim Gille, Olivier Kieser, David Christopher |
author_facet | Parker, Jack Soltani, Sherry Boissiere, Louis Obeid, Ibrahim Gille, Olivier Kieser, David Christopher |
author_sort | Parker, Jack |
collection | PubMed |
description | AIM: To review the published literature on the treatment of aneurysmal bone cysts (ABCs). METHOD: A systematic review of the English literature to April 2019 for all articles, with a minimum of three patients and 2-year follow-up, reporting on the treatment of spinal ABCs. The various treatment options were compared for the rates of recurrence, complications and mortality. RESULTS: Twenty-one articles and 272 patients (mean age 16.9 years, range 3–67) were included in this review. The overall recurrence rate for ABCs following all treatments is 12.8%. This is highest in those lesions described as being treated with isolated surgiflo injection into the lesion (100%), decompression/laminectomy (42.3%), partial excision/resection (35.7%) and curettage alone (25.0%). Radiotherapy alone or in conjunction with operative intervention offers excellent cure rates. Adjuncts to operative intervention, including cryotherapy or phenol reduce the recurrence rates, whereas embolization does not. The most common complications are persistent neurological deficits, spinal deformity, and continued pain. The overall mortality rates are low (1.5%). The reoperation rates are higher in surgical than non-surgical treatments and most are performed for progressive deformity. DISCUSSION: ABCs are highly radiosensitive. However, with the unknown longer-term risk of radiotherapy, surgical treatments, ideally with complete resection, and the use of adjunctive therapies such as cryotherapy or phenol, offer the best chance of cure. SAE is a useful adjunct to reduce intraoperative bleeding, but this study suggests that it only modestly improves recurrence rates. Newer techniques including bisphosphonate and doxycycline administration offer potential benefits, but their efficacy requires further investigation. |
format | Online Article Text |
id | pubmed-6817493 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-68174932019-11-06 Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management Parker, Jack Soltani, Sherry Boissiere, Louis Obeid, Ibrahim Gille, Olivier Kieser, David Christopher Orthop Res Rev Review AIM: To review the published literature on the treatment of aneurysmal bone cysts (ABCs). METHOD: A systematic review of the English literature to April 2019 for all articles, with a minimum of three patients and 2-year follow-up, reporting on the treatment of spinal ABCs. The various treatment options were compared for the rates of recurrence, complications and mortality. RESULTS: Twenty-one articles and 272 patients (mean age 16.9 years, range 3–67) were included in this review. The overall recurrence rate for ABCs following all treatments is 12.8%. This is highest in those lesions described as being treated with isolated surgiflo injection into the lesion (100%), decompression/laminectomy (42.3%), partial excision/resection (35.7%) and curettage alone (25.0%). Radiotherapy alone or in conjunction with operative intervention offers excellent cure rates. Adjuncts to operative intervention, including cryotherapy or phenol reduce the recurrence rates, whereas embolization does not. The most common complications are persistent neurological deficits, spinal deformity, and continued pain. The overall mortality rates are low (1.5%). The reoperation rates are higher in surgical than non-surgical treatments and most are performed for progressive deformity. DISCUSSION: ABCs are highly radiosensitive. However, with the unknown longer-term risk of radiotherapy, surgical treatments, ideally with complete resection, and the use of adjunctive therapies such as cryotherapy or phenol, offer the best chance of cure. SAE is a useful adjunct to reduce intraoperative bleeding, but this study suggests that it only modestly improves recurrence rates. Newer techniques including bisphosphonate and doxycycline administration offer potential benefits, but their efficacy requires further investigation. Dove 2019-10-24 /pmc/articles/PMC6817493/ /pubmed/31695521 http://dx.doi.org/10.2147/ORR.S211834 Text en © 2019 Parker et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Review Parker, Jack Soltani, Sherry Boissiere, Louis Obeid, Ibrahim Gille, Olivier Kieser, David Christopher Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management |
title | Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management |
title_full | Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management |
title_fullStr | Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management |
title_full_unstemmed | Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management |
title_short | Spinal Aneurysmal Bone Cysts (ABCs): Optimal Management |
title_sort | spinal aneurysmal bone cysts (abcs): optimal management |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817493/ https://www.ncbi.nlm.nih.gov/pubmed/31695521 http://dx.doi.org/10.2147/ORR.S211834 |
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