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Treatment of Spinal Aneurysmal Bone Cyst with Percutaneous Injection of Hydroxyapatite Osteoconductive Cement

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  • Musculoskeletal Interventions
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Abstract

Purpose

The aim of this study was to evaluate treatment efficacy of percutaneous injection of hydroxyapatite-osteoconductive-cement in patients with spinal aneurysmal bone cysts.

Materials and Methods

The study was designed as a retrospective observational clinical study. We included patients who were diagnosed with of spinal aneurysmal bone cyst, at our institution between 2013 and 2020, and treated with percutaneous injection of osteoconductive cement: “Cerament”® (BONESUPPORT AB, Lund, Sweden). Typical clinical and radiological features of the ABCs treatment and follow-up were investigated.

Results

Our study included nine patients, two children and seven adults. Three different types of approaches were applied: (single pedicle approach in 3 patients; double pedicle approach in 2 patients; while in the remaining cases, a multiple access approach was used. VAS score decreased from 8.5 ± 0.5 before treatment to 4.1 ± 0.9 at 6-months-follow up. All of the patients reacted well to treatment, with none neurological complications, complete loss of pain and achieved osteosclerosis as radiological marker of treatment success.

Conclusion

Treatment of symptomatic spinal ABC’s with hydroxyapatite cement is effective to achieve complete pain reduction and sclerosis.

Graphical Abstract

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References

  1. Aljamaan YM, Alhathloul HS, Aleissa SI, Abaalkhail MS, Alhelal FH, Konbaz FM. Unusual presentation of aneurysmal bone cyst with scoliosis: a case report. J Med Case Rep. 2022;16(1):446. https://doi.org/10.1186/s13256-022-03685-0.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kransdorf MJ, Sweet DE. Aneurysmal bone cyst: Concept, controversy, clinical presentation, and imaging. AJR Am J Roentgenol. 1995;164(3):573–80. https://doi.org/10.2214/ajr.164.3.7863874. (PMID: 7863874).

    Article  CAS  PubMed  Google Scholar 

  3. Saccomanni B. Aneurysmal bone cyst of spine: A review of literature. Arch Orthop Trauma Surg. 2008;128(10):1145–7. https://doi.org/10.1007/s00402-007-0477-6. (Epub 2007 Oct 9 PMID: 17922280).

    Article  CAS  PubMed  Google Scholar 

  4. Jayakumar N, Ismail HMB, Mulay S, Ashwood N. Aneurysmal bone cyst in the cervical spine. BMJ Case Rep. 2019;12(10):e231870. https://doi.org/10.1136/bcr-2019-231870.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mankin HJ, Hornicek FJ, Ortiz-Cruz E, Villafuerte J, Gebhardt MC. Aneurysmal bone cyst: A review of 150 patients. J Clin Oncol. 2005;23(27):6756–62. https://doi.org/10.1200/JCO.2005.15.255. (PMID: 16170183).

    Article  PubMed  Google Scholar 

  6. Stevens KJ, Stevens JA. Aneurysmal bone cysts. 2022. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, PMID: 31536260.

  7. Hudson TM. Fluid levels in aneurysmal bone cysts: A CT feature. AJR Am J Roentgenol. 1984;142(5):1001–4. https://doi.org/10.2214/ajr.142.5.1001.

    Article  CAS  PubMed  Google Scholar 

  8. Mahnken AH, Nolte-Ernsting CC, Wildberger JE, et al. Aneurysmal bone cyst: Value of MR imaging and conventional radiography. Eur Radiol. 2003;13(5):1118–24. https://doi.org/10.1007/s00330-002-1668-8.

    Article  CAS  PubMed  Google Scholar 

  9. Tsagozis P, Brosjö O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev. 2015;7(4):6182. https://doi.org/10.4081/or.2015.6182.

    Article  Google Scholar 

  10. Frassanito P, D’Onofrio GF, Pennisi G, et al. Multimodal management of aggressive recurrent aneurysmal bone cyst of Spine: Case report and review of literature. World Neurosurg. 2019;126:423–7. https://doi.org/10.1016/j.wneu.2019.02.246.

    Article  PubMed  Google Scholar 

  11. Bohatyrewicz A, Bohatyrewicz R, Dobiecki K, Kotrych D, Kamiński A, Zienkiewicz M. Is retrieval of bone material from multiorgan donors effective enough to cover demand for biostatic bone tissue grafts in Poland? Transplant Proc. 2006;38:297–300.

    Article  CAS  PubMed  Google Scholar 

  12. Nusselt T, Hofmann A, Wachtlin D, Gorbulev S, Rommens PM. CERAMENT treatment of fracture defects (CERTiFy): Protocol for a prospective, multicenter, randomized study investigating the use of CERAMENT™ BONE VOID FILLER in tibial plateau fractures. Trials. 2014;15:75. https://doi.org/10.1186/1745-6215-15-75.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Masala S, Nano G, Marcia S, Muto M, Fucci FP, Simonetti G. Osteoporotic vertebral compression fractures augmentation by injectable partly resorbable ceramic bone substitute (Cerament™|SPINE SUPPORT): A prospective nonrandomized study. Neuroradiology. 2012;54(6):589–96. https://doi.org/10.1007/s00234-011-0940-5.

    Article  PubMed  Google Scholar 

  14. Guarnieri G, Vassallo P, Muto M, Muto M. Percutaneous treatment of symptomatic aneurysmal bone cyst of L5 by percutaneous injection of osteoconductive material (Cerament). BMJ Case Rep. 2013;2013:bcr2013010912. https://doi.org/10.1136/bcr-2013-010912.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Holmes RE, Wardrop RW, Wolford LM. Hydroxylapatite as a bone graft substitute in orthognathic surgery: Histologic and histometric findings. J Oral Maxillofac Surg. 1988;46(8):661–71. https://doi.org/10.1016/0278-2391(88)90109-7.

    Article  CAS  PubMed  Google Scholar 

  16. Kotrych D, Korecki S, Ziętek P, et al. Preliminary results of highly injectable Bi-phasic bone substitute (CERAMENT) in the treatment of benign bone tumors and tumor-like lesions. Open Med. 2018;13:487–92. https://doi.org/10.1515/med-2018-0072.

    Article  CAS  Google Scholar 

  17. Keçeci B, Küçük L, Isayev A, Sabah D. Effect of adjuvant therapies on recurrence in aneurysmal bone cysts. Acta Orthop Traumatol Turc. 2014;48(5):500–6. https://doi.org/10.3944/AOTT.2014.14.0020.

    Article  PubMed  Google Scholar 

  18. Rossi G, Mavrogenis AF, Rimondi E, et al. Selective arterial embolisation for bone tumours: Experience of 454 cases. Radiol Med. 2011;116(5):793–808. https://doi.org/10.1007/s11547-011-0670-0.

    Article  CAS  PubMed  Google Scholar 

  19. Varshney MK, Rastogi S, Khan SA, Trikha V. Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts? Clin Orthop Relat Res. 2010;468(6):1649–59. https://doi.org/10.1007/s11999-009-1144-8.

    Article  PubMed  Google Scholar 

  20. Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: A reanalysis of two clinical trials of postoperative pain. J Pain. 2003;4(7):407–14. https://doi.org/10.1016/s1526-5900(03)00716-8.

    Article  PubMed  Google Scholar 

  21. Zenonos G, Jamil O, Governale LS, Jernigan S, Hedequist D, Proctor MR. Surgical treatment for primary spinal aneurysmal bone cysts: Experience from Children’s Hospital Boston. J Neurosurg Pediatr. 2012;9(3):305–15. https://doi.org/10.3171/2011.12.PEDS11253.

    Article  PubMed  Google Scholar 

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Funding

This study was not supported by any funding.

Author information

Authors and Affiliations

  1. Faculty of Medicine, The University of Campania Luigi Vanvitelli, Caserta, Italy

    Eduardo Gragnano

  2. Diagnostic and Interventional Neuroradiology Unit, A.O.R.N. Cardarelli, Naples, Italy

    Valentina Opancina, Flavio Giordano, Gianluigi Guarnieri, Luigi Della Gata & Mario Muto

  3. Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

    Valentina Opancina

  4. Service de Radiologie, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland

    Gianluca Muto

  5. Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Joshua Hirsch

  6. U.O.C. of Neuroradiology, Department of Health Services, Carlo Poma Hospital, ASST-Mantova, Mantua, Italy

    Enrico Piovan

Authors
  1. Eduardo Gragnano
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  2. Valentina Opancina
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  3. Gianluca Muto
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  4. Flavio Giordano
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  5. Gianluigi Guarnieri
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  6. Joshua Hirsch
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  7. Luigi Della Gata
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  8. Enrico Piovan
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  9. Mario Muto
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Corresponding author

Correspondence to Valentina Opancina.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Gragnano, E., Opancina, V., Muto, G. et al. Treatment of Spinal Aneurysmal Bone Cyst with Percutaneous Injection of Hydroxyapatite Osteoconductive Cement. Cardiovasc Intervent Radiol 46, 1726–1731 (2023). https://doi.org/10.1007/s00270-023-03606-8

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  • DOI: https://doi.org/10.1007/s00270-023-03606-8

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