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Percutaneous albumin/doxycycline injection versus open surgery for aneurysmal bone cysts in the mobile spine

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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References

  1. Amendola L, Simonetti L, Simoes CE, Bandiera S, De IF, Boriani S (2013) Aneurysmal bone cyst of the mobile spine: the therapeutic role of embolization. Eur Spine J 22(3):533–541

    Article  CAS  Google Scholar 

  2. Boriani S, De IF, Campanacci L, Gasbarrini A, Bandiera S, Biagini R et al (2001) Aneurysmal bone cyst of the mobile spine: report on 41 cases. Spine 26(1):27–35

    Article  CAS  Google Scholar 

  3. Hay MC, Paterson D, Taylor TK (1978) Aneurysmal bone cysts of the spine. J Bone Jt Surg Br 60-B (3):406

    Article  Google Scholar 

  4. Burch S, Hu S, Berven S (2008) Aneurysmal bone cysts of the spine. Neurosurg Clin N Am 19(1):41–47

    Article  Google Scholar 

  5. Dal CP, Kozakewich HP, Goumnerova L, Mankin HJ, Rosenberg AE, Fletcher JA (2000) Variant translocations involving 16q22 and 17p13 in solid variant and extraosseous forms of aneurysmal bone cyst. Genes Chromosomes Cancer 28:233–234

    Article  Google Scholar 

  6. Oliveira AM, Chou MM (2014) Usp6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol 45(1):1–11

    Article  CAS  Google Scholar 

  7. Tsagozis P, Brosjö O (2015) Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev 7(4):6182

    Article  Google Scholar 

  8. Shiels WE, Mayerson JL (2013) Percutaneous doxycycline treatment of aneurysmal bone cysts with low recurrence rate: a preliminary report. Clin Orthop Relat Res 471(8):2675–2683

    Article  Google Scholar 

  9. Doyle A, Field A, Graydon A (2015) Recurrent aneurysmal bone cyst of the cervical spine in childhood treated with doxycycline injection. Skelet Radiol 44(4):609–612

    Article  Google Scholar 

  10. Fisher CG, Dipaola CP, Ryken TC, Bilsky MH, Shaffrey CI, Berven SH et al (2010) A novel classification system for spinal instability in neoplastic disease: an evidence based approach and expert consensus from the spine oncology study group. Spine 35(22):1221–1229

    Article  Google Scholar 

  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):455–462

    Google Scholar 

  12. Choi D, Crockard A, Bunger C, Harms J, Kawahara N, Mazel C et al (2010) Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the global spine tumour study group. Eur Spine J 19(2):215–222

    Article  Google Scholar 

  13. Boriani S, Lo SF, Puvanesarajah V, Fisher CG, Varga PP, Rhines LD et al (2014) Aneurysmal bone cysts of the spine: treatment options and considerations. J Neurooncol 120(1):171–178

    Article  Google Scholar 

  14. Barbanti-Brodano G, Girolami M, Ghermandi R, Terzi S, Gasbarrini A, Bandiera S et al (2017) Aneurysmal bone cyst of the spine treated by concentrated bone marrow: clinical cases and review of the literature. Eur Spine J 26:158–166

    Article  Google 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):312

    CAS  PubMed  Google Scholar 

  16. Gilbertson-Beadling S, Powers EA, Stamp-Cole M, Scott PS, Wallace TL, Copeland J et al (1995) The tetracycline analogs minocycline and doxycycline inhibit angiogenesis in vitro by a non-metalloproteinase-dependent mechanism. Cancer Chemother Pharmacol 36(5):418–424

    Article  CAS  Google Scholar 

  17. Sahin S, Selek H, Ponchel G, Ercan MT, Sargon M, Hincal AA et al (2002) Preparation, characterization and in vivo distribution of terbutaline sulfate loaded albumin microspheres. J Control Release 82(2):345–358

    Article  CAS  Google Scholar 

  18. Tessari L, Cavezzi A, Frullini A (2001) Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg 27:58–60

    CAS  PubMed  Google Scholar 

  19. Shibuya I, Dezawa A, Urayama S, Nakamura S (2018) Surgical treatment of a lumbar aneurysmal bone cyst using percutaneous endoscopic lumbar discectomy. Eur Spine J 27:368–374

    Article  Google Scholar 

  20. Reddy KI, Sinnaeve F, Gaston CL, Grimer RJ, Carter SR (2014) Aneurysmal bone cysts: do simple treatments work? Clin Orthop Relat Res 472(6):1901–1910

    Article  Google Scholar 

  21. Steffner RJ, Liao C, Stacy G, Atanda A, Attar S, Avedian R et al (2011) Factors associated with recurrence of primary aneurysmal bone cysts: is argon beam coagulation an effective adjuvant treatment? J Bone Jt Surg Am 93:e1221–e1229

    Article  Google 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):4082–4086

    PubMed  Google Scholar 

  23. Dormans JP, Hanna BG, Johnston DR, Khurana JS (2004) Surgical treatment and recurrence rate of aneurysmal bone cysts in children. Clin Orthop Relat Res 421:205–211

    Article  Google Scholar 

  24. Gibbs CP Jr, Hefele MC, Peabody TD, Montag AG, Aithal V, Simon MA (1999) Aneurysmal bone cyst of the extremities. Factors related to local recurrence after curettage with a high-speed burr. J Bone Jt Surg Am 81(12):1671–1678

    Article  Google Scholar 

  25. Ramírez AR, Stanton RP (2002) Aneurysmal bone cyst in 29 children. J Pediatr Orthop 22(4):533

    PubMed  Google Scholar 

  26. Cottalorda J, Kohler R, Chotel F, de Gauzy J, Lefort G, Louahem D et al (2005) Recurrence of aneurysmal bone cysts in young children: a multicentre study. J Pediatr Orthop B 14(3):212–218

    Article  Google 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 82:474–483

    CAS  PubMed  Google Scholar 

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Acknowledgements

We thank Mrs. Chen Mei REN for her help in data collection.

Funding

This study was funded by Peking University Third Hospital (Y71508-01).

Author information

Author notes

  1. Xiao Liu, Song Bo Han, and Gao Si contribute equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China

    Xiao Liu, Gao Si, Liang Jiang, Feng Wei, Feng Liang Wu, Xiao Guang Liu & Zhong Jun Liu

  2. Department of Radiology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China

    Song Bo Han

  3. Peking University Health Science Center, No. 38 Xue Yuan Road, Haidian District, Beijing, 100191, China

    Gao Si

  4. Department of Pathology, Peking University Health Science Center, Beijing, 100191, China

    Shao Ming Yang

  5. Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China

    Chang Ming Wang

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  1. Xiao Liu
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Corresponding authors

Correspondence to Liang Jiang or Zhong Jun Liu.

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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.

Ethical approval

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”.

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Liu, X., Han, S.B., Si, G. et al. Percutaneous albumin/doxycycline injection versus open surgery for aneurysmal bone cysts in the mobile spine. Eur Spine J 28, 1529–1536 (2019). https://doi.org/10.1007/s00586-018-5836-1

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  • DOI: https://doi.org/10.1007/s00586-018-5836-1

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