Aneurysmal bone cyst of the cervical spine in children

Eduardo N. Novais, Peter S. Rose, Michael J Yaszemski, Franklin H. Sim

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Approximately 50% of patients with aneurysmal bone cyst of the spine are in the pediatric age group. Aneurysmal bone cyst is considered a locally aggressive benign tumor that may involve the posterior and anterior elements of the spine. Intralesional extended curettage and bone-grafting is the mainstay of treatment of aneurysmal bone cysts involving the long bones. However, the proximity to neurovascular structures and the potential remaining growth of the spine make its management in the spine more challenging. We evaluated the clinical presentation and the results of surgical treatment, following complete intralesional curettage along with spinal arthrodesis in pediatric patients with aneurysmal bone cysts of the cervical spine. Methods: We retrospectively reviewed the cases of seven children who were surgically treated for a primary aneurysmal bone cyst of the cervical spine between 1988 and 2008. There were four boys and three girls who had a mean age of 11.9 years (range, eight to 16.2 years) at the time of diagnosis. The mean duration of follow-up was 46.5 months (range, twentysix to ninety-eight months). The mean age at the time of follow-up was sixteen years (range, 10.6 to 24.6 years). Results: Neck pain was the most common presenting symptom, and radiculopathy was the most common finding on physical examination. Radiographs, computed tomography, and magnetic resonance imaging were highly suggestive for the diagnosis that was confirmed histologically in all patients. The majority (four) of the patients required combined anterior and posterior approaches for complete removal of the tumor and arthrodesis of the spine. Two patients required additional procedures: one for a local recurrence and one for nonunion of the atlantooccipital junction. All patients were free of evidence of recurrent disease at the time of the last follow-up. With the exception of one patient who had permanent Horner syndrome, all patients were asymptomatic. Conclusions: Preoperative arterial embolization, complete tumor excision by intralesional curettage and burring, followed by local spinal fusion, yield satisfactory results with a low rate of complications and low recurrence in children with an aneurysmal bone cyst of the cervical spine. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)1534-1543
Number of pages10
JournalJournal of Bone and Joint Surgery - Series A
Volume93
Issue number16
DOIs
StatePublished - Aug 17 2011

Fingerprint

Aneurysmal Bone Cysts
Spine
Curettage
Arthrodesis
Pediatrics
Horner Syndrome
Recurrence
Neoplasms
Spinal Fusion
Radiculopathy
Bone Transplantation
Neck Pain
Physical Examination
Therapeutics
Age Groups
Tomography
Magnetic Resonance Imaging
Bone and Bones

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Aneurysmal bone cyst of the cervical spine in children. / Novais, Eduardo N.; Rose, Peter S.; Yaszemski, Michael J; Sim, Franklin H.

In: Journal of Bone and Joint Surgery - Series A, Vol. 93, No. 16, 17.08.2011, p. 1534-1543.

Research output: Contribution to journalArticle

Novais, Eduardo N. ; Rose, Peter S. ; Yaszemski, Michael J ; Sim, Franklin H. / Aneurysmal bone cyst of the cervical spine in children. In: Journal of Bone and Joint Surgery - Series A. 2011 ; Vol. 93, No. 16. pp. 1534-1543.
@article{c98a096b61d443f2aaafbbef58d72fd1,
title = "Aneurysmal bone cyst of the cervical spine in children",
abstract = "Background: Approximately 50{\%} of patients with aneurysmal bone cyst of the spine are in the pediatric age group. Aneurysmal bone cyst is considered a locally aggressive benign tumor that may involve the posterior and anterior elements of the spine. Intralesional extended curettage and bone-grafting is the mainstay of treatment of aneurysmal bone cysts involving the long bones. However, the proximity to neurovascular structures and the potential remaining growth of the spine make its management in the spine more challenging. We evaluated the clinical presentation and the results of surgical treatment, following complete intralesional curettage along with spinal arthrodesis in pediatric patients with aneurysmal bone cysts of the cervical spine. Methods: We retrospectively reviewed the cases of seven children who were surgically treated for a primary aneurysmal bone cyst of the cervical spine between 1988 and 2008. There were four boys and three girls who had a mean age of 11.9 years (range, eight to 16.2 years) at the time of diagnosis. The mean duration of follow-up was 46.5 months (range, twentysix to ninety-eight months). The mean age at the time of follow-up was sixteen years (range, 10.6 to 24.6 years). Results: Neck pain was the most common presenting symptom, and radiculopathy was the most common finding on physical examination. Radiographs, computed tomography, and magnetic resonance imaging were highly suggestive for the diagnosis that was confirmed histologically in all patients. The majority (four) of the patients required combined anterior and posterior approaches for complete removal of the tumor and arthrodesis of the spine. Two patients required additional procedures: one for a local recurrence and one for nonunion of the atlantooccipital junction. All patients were free of evidence of recurrent disease at the time of the last follow-up. With the exception of one patient who had permanent Horner syndrome, all patients were asymptomatic. Conclusions: Preoperative arterial embolization, complete tumor excision by intralesional curettage and burring, followed by local spinal fusion, yield satisfactory results with a low rate of complications and low recurrence in children with an aneurysmal bone cyst of the cervical spine. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.",
author = "Novais, {Eduardo N.} and Rose, {Peter S.} and Yaszemski, {Michael J} and Sim, {Franklin H.}",
year = "2011",
month = "8",
day = "17",
doi = "10.2106/JBJS.J.01430",
language = "English (US)",
volume = "93",
pages = "1534--1543",
journal = "Journal of Bone and Joint Surgery - American Volume",
issn = "0021-9355",
publisher = "Journal of Bone and Joint Surgery Inc.",
number = "16",

}

TY - JOUR

T1 - Aneurysmal bone cyst of the cervical spine in children

AU - Novais, Eduardo N.

AU - Rose, Peter S.

AU - Yaszemski, Michael J

AU - Sim, Franklin H.

PY - 2011/8/17

Y1 - 2011/8/17

N2 - Background: Approximately 50% of patients with aneurysmal bone cyst of the spine are in the pediatric age group. Aneurysmal bone cyst is considered a locally aggressive benign tumor that may involve the posterior and anterior elements of the spine. Intralesional extended curettage and bone-grafting is the mainstay of treatment of aneurysmal bone cysts involving the long bones. However, the proximity to neurovascular structures and the potential remaining growth of the spine make its management in the spine more challenging. We evaluated the clinical presentation and the results of surgical treatment, following complete intralesional curettage along with spinal arthrodesis in pediatric patients with aneurysmal bone cysts of the cervical spine. Methods: We retrospectively reviewed the cases of seven children who were surgically treated for a primary aneurysmal bone cyst of the cervical spine between 1988 and 2008. There were four boys and three girls who had a mean age of 11.9 years (range, eight to 16.2 years) at the time of diagnosis. The mean duration of follow-up was 46.5 months (range, twentysix to ninety-eight months). The mean age at the time of follow-up was sixteen years (range, 10.6 to 24.6 years). Results: Neck pain was the most common presenting symptom, and radiculopathy was the most common finding on physical examination. Radiographs, computed tomography, and magnetic resonance imaging were highly suggestive for the diagnosis that was confirmed histologically in all patients. The majority (four) of the patients required combined anterior and posterior approaches for complete removal of the tumor and arthrodesis of the spine. Two patients required additional procedures: one for a local recurrence and one for nonunion of the atlantooccipital junction. All patients were free of evidence of recurrent disease at the time of the last follow-up. With the exception of one patient who had permanent Horner syndrome, all patients were asymptomatic. Conclusions: Preoperative arterial embolization, complete tumor excision by intralesional curettage and burring, followed by local spinal fusion, yield satisfactory results with a low rate of complications and low recurrence in children with an aneurysmal bone cyst of the cervical spine. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

AB - Background: Approximately 50% of patients with aneurysmal bone cyst of the spine are in the pediatric age group. Aneurysmal bone cyst is considered a locally aggressive benign tumor that may involve the posterior and anterior elements of the spine. Intralesional extended curettage and bone-grafting is the mainstay of treatment of aneurysmal bone cysts involving the long bones. However, the proximity to neurovascular structures and the potential remaining growth of the spine make its management in the spine more challenging. We evaluated the clinical presentation and the results of surgical treatment, following complete intralesional curettage along with spinal arthrodesis in pediatric patients with aneurysmal bone cysts of the cervical spine. Methods: We retrospectively reviewed the cases of seven children who were surgically treated for a primary aneurysmal bone cyst of the cervical spine between 1988 and 2008. There were four boys and three girls who had a mean age of 11.9 years (range, eight to 16.2 years) at the time of diagnosis. The mean duration of follow-up was 46.5 months (range, twentysix to ninety-eight months). The mean age at the time of follow-up was sixteen years (range, 10.6 to 24.6 years). Results: Neck pain was the most common presenting symptom, and radiculopathy was the most common finding on physical examination. Radiographs, computed tomography, and magnetic resonance imaging were highly suggestive for the diagnosis that was confirmed histologically in all patients. The majority (four) of the patients required combined anterior and posterior approaches for complete removal of the tumor and arthrodesis of the spine. Two patients required additional procedures: one for a local recurrence and one for nonunion of the atlantooccipital junction. All patients were free of evidence of recurrent disease at the time of the last follow-up. With the exception of one patient who had permanent Horner syndrome, all patients were asymptomatic. Conclusions: Preoperative arterial embolization, complete tumor excision by intralesional curettage and burring, followed by local spinal fusion, yield satisfactory results with a low rate of complications and low recurrence in children with an aneurysmal bone cyst of the cervical spine. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

UR - http://www.scopus.com/inward/record.url?scp=80052831118&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052831118&partnerID=8YFLogxK

U2 - 10.2106/JBJS.J.01430

DO - 10.2106/JBJS.J.01430

M3 - Article

VL - 93

SP - 1534

EP - 1543

JO - Journal of Bone and Joint Surgery - American Volume

JF - Journal of Bone and Joint Surgery - American Volume

SN - 0021-9355

IS - 16

ER -