Percutaneous albumin/doxycycline injection versus open surgery for aneurysmal bone cysts in the mobile spine
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This study aimed to validate the safety and effectiveness of percutaneous doxycycline/albumin injection for spinal aneurysmal bone cysts (ABCs) as an alternative to open surgery.
From January 2000 to December 2016, 25 patients who had no/minor neurological deficits (modified Frankel scale D or E) and acceptable local stability (spinal instability neoplastic score < 12) were included in the study, of whom 14 were treated with percutaneous doxycycline/albumin injection (injection group) and 11 were treated with open surgery (surgery group). The demographic and clinical information of the injection and surgery groups were recorded and compared.
In the injection group, lesion size was significantly reduced in all 14 patients, all patients showed complete neurological recovery, and 13 patients had complete relief of neck pain; their mean visual analogue scale (VAS) decreased from 3.4 to 0.5. No complication or recurrence was observed during the mean 30.7-month follow-up (range, 24–50 months). In the surgery group, 9 patients had complete neurological recovery and 2 patients had residual slight paresthesia; their mean VAS decreased from 3.4 to 0.5. Two had local recurrence during their follow-up at 66.5 months (range, 50–96 months). Compared with the surgery group, the injection group showed no significant difference in the rate of recurrence (P = 0.14) and complication (P = 0.36).
Percutaneous doxycycline/albumin injection for spinal ABCs can be safely and effectively performed in well-selected cases. It could serve as an alternative treatment, especially for spinal ABCs lesions with acceptable local stability and in patients without severe neurological deficits.
KeywordsSpinal tumor Aneurysmal bone cyst Percutaneous doxycycline treatment Open surgery Recurrence
We thank Mrs. Chen Mei REN for her help in data collection.
This study was funded by Peking University Third Hospital (Y71508-01).
Compliance with ethical standards
Conflict of interest
Xiao Liu, Song Bo Han, Gao Si, Shao Ming Yang, Chang Ming Wang, Liang Jiang, Feng Wei, Feng Liang Wu, Xiao Guang Liu, Zhong Jun Liu declare that they have no conflict of interest.
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 Declaration of Helsinki and its later amendments or comparable ethical standards. “For this type of study, formal consent is not required”.
- 11.Feldman JP, Goldwasser R, Mark S, Schwartz J (2009) A mathematical model for tumor volume evaluation using two-dimensions. J Appl Quant Methods 4(4):455–462Google Scholar
- 15.Duivenvoorden WC, Hirte HW, Singh G (1997) Use of tetracycline as an inhibitor of matrix metalloproteinase activity secreted by human bone-metastasizing cancer cells. Invasion Metastasis 17(6):312Google Scholar
- 18.Tessari L, Cavezzi A, Frullini A (2001) Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg 27:58–60Google Scholar
- 22.Wang C, Liu X, Jiang L, Yang S, Wei F, Wu F et al (2014) Treatments for primary aneurysmal bone cysts of the cervical spine: experience of 14 cases. Chin Med J 127(23):4082–4086Google Scholar
- 25.Ramírez AR, Stanton RP (2002) Aneurysmal bone cyst in 29 children. J Pediatr Orthop 22(4):533Google Scholar
- 27.Hauschild O, Lüdemann M, Engelhardt M, Baumhoer D, Baumann T, Elger T et al (2016) Aneurysmal bone cyst (ABC): treatment options and proposal of a follow-up regime. Acta Orthop Belg 82:474–483Google Scholar