Technical Report

Skeletal Radiology

, Volume 40, Issue 11, pp 1461-1466

Advance in the treatment of aneurysmal bone cyst of the sacrum

  • Davide DonatiAffiliated withII Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute Email author 
  • , Tommaso FrisoniAffiliated withII Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute
  • , Barbara DozzaAffiliated withLaboratory of Bone Regeneration, Rizzoli Orthopaedic Institute
  • , Henry DeGrootAffiliated withNewton Wellesley Hospital
  • , Ugo AlbisinniAffiliated withRadiology Unit, Rizzoli Orthopaedic Institute
  • , Sandro GianniniAffiliated withII Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute

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Abstract

Objective

The objective of this study was the review of 11 patients with two different treatment methods used historically for aneurysmal bone cyst in the sacrum. The outcome of both procedures is reported. In addition, the treatment technique of CT-guided percutaneous injections of demineralized bone matrix mixed with bone marrow concentrate is described.

Materials and methods

From 1997 to 2008, 11 patients with sacral aneurysmal bone cyst were treated at the Rizzoli Institute, Bologna, Italy. The first seven patients had surgical curettage without bone grafting, chemical adjuvants, or arterial embolization. The last four patients had arterial embolization. The last patient did not respond to arterial embolization and was treated by CT-guided injection of demineralized bone matrix mixed with bone marrow concentrate.

Results

Curettage was successful in five out of seven patients. Two patients suffered complications, and two cases had recurrence. Arterial embolization was successful in three of four patients. The patient treated with injection had a good clinical and radiographic result.

Conclusion

Both surgical and arterial embolization are effective for aneurysmal bone cyst in the sacrum. However, these treatments may lead to complications and recurrence. The use of CT-guided injections of demineralized bone matrix mixed with bone marrow concentrate may be a safe and effective alternative for treatment of these destructive and problematic lesions.

Keywords

Aneurysmal bone cyst Pseudo tumoral lesion Sacral location Regenerative medicine