Symptomatic aneurysmal bone cysts of the spine: clinical features, surgical outcomes, and prognostic factors
The aim of the study was to report the long-term outcomes and analyze the potential prognostic factors that may contribute to symptomatic patients with aneurysmal bone cyst (ABC) of the spine undergoing surgical treatments.
A retrospective analysis of consecutive patients with ABCs of the spine was performed. The clinical features were reviewed, and the disease-free survival (DFS) and overall survival (OS) rates were estimated using the Kaplan–Meier method. Factors with p values ≤ 0.05 were subjected to multivariate analysis by Cox proportional hazards model to identify the independent prognostic contributors. p values < 0.05 were considered statistically significant.
A total of 42 patients with ABCs of the spine were included in the study. All patients received surgical treatments. The mean follow-up period was 41.3 months (median 39.5, range 24–64). Local recurrence was detected in eight patients after surgery in our center, whereas death occurred in three patients. The estimated 5-year DFS and OS rate was 54.1% and 76.8%, respectively. The statistical analyses indicated that both en bloc resection and primary/secondary tumor status were independent prognostic factors for DFS.
Secondary ABC status may be associated with worse prognosis, and en bloc resection remains the treatment of choice for ABCs with neurologic deficits or spinal instability of the spine, which is correlated with better prognosis for local tumor control.
KeywordsAneurysmal bone cyst En bloc Prognosis Disease-free survival Recurrence
This study was supported by the National Natural Science Foundation of China (81702888), Shanghai excellent medical talents funding (2018YQ56), and Shanghai Youth doctor assistance program (Wei Xu).
Compliance with ethical standards
Conflict of interest
We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, and there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript.
- 13.Kricun ME (1993) Tumors of the spine. In: Kricun ME (ed) Imaging of bone tumors. WB Saunders Company, Philadelphia, pp 256–303Google Scholar
- 14.Terzi S, Gasbarrini A, Fuiano M, Barbanti Brodano G, Ghermandi R, Bandiera S et al (2017) Efficacy and safety of selective arterial embolization in the treatment of aneurysmal bone cyst of the mobile spine: a retrospective observational study. Spine (Phila Pa 1976) 42:1130–1138CrossRefGoogle Scholar
- 15.Frankel HL, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH et al (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I. Paraplegia 7:179–192Google Scholar
- 17.Enneking WF (1986) A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res (204):9–24Google Scholar
- 23.Campanacci M, Cervellati C, Donati U, Bertoni F (1976) Aneurysmal bone cyst (a study of 127 cases, 72 with long-term follow up). Ital J Orthop Traumatol 2:341–353Google Scholar