Spinal Aneurysmal Bone Cysts: Surgical Options and Clinical Outcome

Abstract Background: Aneurysmal bone cyst (ABC) of the spine is a rare entity. Treatment of these lesions is challenging. There are many surgical and nonsurgical options for manage-ment of spinal ABCs. Aim of Study: The aim of this study was to describe the surgical options and the clinical outcome of aneurysmal bone cysts of the spine. Patients and Methods: This is a retrospective study done on six patients with primary spinal ABCs. A modified Frankel scale was used for assessment of the neurological status of the patients preoperatively and during the follow-up period. The WBB (Weinstein-Boriani-Biagini) system was used to describe the extent of the lesion depending on the data collected from magnetic resonance imaging (MRI) and computed tom-ography (CT) scans. Results: The mean age was 20.3±5.9 (range, 15-30) years. There were four females (66.7%) and two males (33.3%). All the patients were stage ABCD according WBB surgical staging system. The surgical excision was complete in four patients (66.7%) and partial in two patients (33.3%). Out of the four patients who presented with neurological deficit, two patients (50%) improved markedly, one patient (25%) had moderate improvement, and the last patient (25%) was stable; three after complete excision and one after partial excision of the tumor. While no recurrences were detected in the patients who had complete excision, the two patients (100%) who had partial excision showed local tumor recurrence. Conclusions: Surgical decompression of spinal ABCs can lead to significant improvement of the preoperative neurolog-ical deficits. In order to decrease the recurrence rate of ABCs of the spine, the goal of surgery should be complete excision.