Minimizing neurovascular complications during image-guided percutaneous cryoablation of a cervical spinal aneurysmal bone cyst using protective doxycycline sclerotherapy: a case report.
J Spine Surg
; 10(1): 159-164, 2024 Mar 20.
Article
em En
| MEDLINE
| ID: mdl-38567007
ABSTRACT
Background:
Aneurysmal bone cysts (ABC) are rare, locally aggressive bone tumors primarily observed in pediatric patients. Surgical curettage is the treatment of choice. Image-guided percutaneous cryoablation (CYOA) is a recently implemented alternative technique in cases not amenable to surgery. CYOA may be limited if the lesion is close to critical neurovascular structures. In this case report, a cervical spinal ABC was successfully treated using CYOA in combination with complementary and protective image-guided percutaneous doxycycline sclerotherapy (DS) to dissect and treat the portion of the lesion in contact with critical structures. Case Description A 4-year-old male presented with a symptomatic ABC within the C5 vertebral body, which encompassed the right vertebral artery and contacted the right C5-C6 spinal cord and nerve roots. After ruling out surgery due to the proximity of critical neurovascular structures, treatment with CYOA was performed. However, subsequent follow-up showed recurrence in the part of the lesion contacting critical structures. A second approach was then decided, using DS to dissect and treat the most vulnerable portion and CYOA to treat the remaining tumor. Follow-up showed almost complete sclerosis of the lesion and total resolution of symptoms 3 years after treatment.Conclusions:
Using DS to dissect and treat the portion of the lesion in contact with critical neurovascular structures during CYOA treatment of a cervical spinal ABC allowed for a safe and effective approach in our case.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
J Spine Surg
Ano de publicação:
2024
Tipo de documento:
Article