Surgical management of pediatric spinal aneurysmal bone cysts: patient series.
J Neurosurg Case Lessons
; 7(4)2024 Jan 22.
Article
en En
| MEDLINE
| ID: mdl-38252929
ABSTRACT
BACKGROUND:
Aneurysmal bone cysts (ABCs) are rare, highly vascular osteolytic bone lesions that predominantly affect pediatric populations. This report evaluates the clinicopathological data of pediatric patients with spinal ABCs. The medical records for all patients at Children's Hospital Los Angeles with biopsy-proven ABCs of the spine between 1998 and 2018 were evaluated. OBSERVATIONS Seventeen patients, 6 males and 11 females, were identified. The mean age at surgery was 10.4 years (range, 3.5-20 years). The most common presenting complaint was pain at the lesion site 16/17 (94%), followed by lower-extremity weakness 8/17 (47%). Resection and intralesional curettage were performed in all patients. Three (18%) of 17 patients underwent selective arterial embolization prior to resection. Spinal stability was compromised in 15 of 17 patients (88%), requiring instrumented fusion. Five (29%) of the 17 patients received additional therapy including radiation, calcitonin-methylprednisolone, or phenol. Four (23.5%) of 17 patients experienced a recurrence, and the mean time to recurrence was 15 months. The postoperative follow-up ranged from 6 to 108 months (median, 28 months). Reoperation occurred after an average of 35 months. At the recent follow-up, patients were free of disease. LESSONS Gross-total resection by intralesional curettage with case-dependent instrumented spinal fusion for instability remains an effective strategy for managing pediatric spinal ABCs. Long-term follow-up is necessary to detect tumor recurrence.
GTR = gross-total resection; ABC = aneurysmal bone cyst; CM = calcitonin-methylprednisolone; CT = computed tomography; EBL = estimated blood loss; MR = magnetic resonance; SAE = selective arterial embolization; STR = subtotal resection; aneurysmal bone cyst; selective arterial embolization; spine; stabilization; tumor recurrence
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1
Colección:
01-internacional
Banco de datos:
MEDLINE
Idioma:
En
Revista:
J Neurosurg Case Lessons
Año:
2024
Tipo del documento:
Article