Surgical treatment of a lumbar aneurysmal bone cyst using percutaneous endoscopic lumbar discectomy

  • Isao Shibuya
  • Akira Dezawa
  • Shigeki Urayama
  • Shigeru Nakamura
Case Report

Abstract

Purpose

Aneurysmal bone cysts of the lumbar spine are usually treated by curettage followed by bone or bioactive ceramics grafting. Here, we present the first case of an aneurysmal bone cyst of the lumbar spine treated by percutaneous endoscopic lumbar discectomy (PELD).

Methods

We describe the clinical characteristics of the patient including the radiological and pathological findings of the tumor and the surgical technique used.

Results

A 15-year-old boy presented with low back pain, and he was diagnosed with an aneurysmal bone cyst of the L3 vertebra based on radiological findings, including plain radiograph, computed tomography, and magnetic resonance imaging. The technique and equipment of PELD were used to perform curettage of the tumor cavity and fill it with hydroxyapatite granules. The skin incision was only 8 mm. The patient was discharged 1 day postoperatively and could walk without assistance. The postoperative course was uneventful and the symptoms improved following surgery.

Conclusion

Endoscopic surgery via PELD can be a treatment option for ABCs of the lumbar spine.

Keywords

Aneurysmal bone cyst Spinal tumor Percutaneous endoscopic lumbar discectomy Lumbar spine 

References

  1. 1.
    Dahlin DC, McLeod RA (1982) Aneurysmal bone cyst and other nonneoplastic conditions. Skelet Radiol 8:243–250CrossRefGoogle Scholar
  2. 2.
    Hay MC, Paterson D, Taylor TK (1978) Aneurysmal bone cysts of the spine. J Bone Jt Surg Br 60-B:406–411Google Scholar
  3. 3.
    Vergel De Dios AM, Bond JR, Shives TC, McLeod RA, Unni KK (1992) Aneurysmal bone cyst. A clinicopathologic study of 238 cases. Cancer 69:2921–2931CrossRefPubMedGoogle Scholar
  4. 4.
    Bhaker P, Mohan H, Handa U, Kumar S (2014) Role of intraoperative pathology consultation in skeletal tumors and tumor-like lesions. Sarcoma 2014:902104. doi:10.1155/2014/902104 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Nobler MP, Higinbotham NL, Phillips RF (1968) The cure of aneurysmal bone cyst. Irradiation superior to surgery in an analysis of 33 cases. Radiology 90:1185–1192. doi:10.1148/90.6.1185 CrossRefPubMedGoogle Scholar
  6. 6.
    Terzi S, Gasbarrini A, Fuiano M, Brodano GB, Ghermandi R, Bandiera S, Boriani S (2016) 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). doi:10.1097/BRS.0000000000002017 Google Scholar
  7. 7.
    Ameli NO, Abbassioun K, Saleh H, Eslamdoost A (1985) Aneurysmal bone cysts of the spine. Report of 17 cases. J Neurosurg 63:685–690. doi:10.3171/jns.1985.63.5.0685 CrossRefPubMedGoogle Scholar
  8. 8.
    Lange T, Stehling C, Frohlich B, Klingenhofer M, Kunkel P, Schneppenheim R, Escherich G, Gosheger G, Hardes J, Jurgens H, Schulte TL (2013) Denosumab: a potential new and innovative treatment option for aneurysmal bone cysts. Eur Spine J 22:1417–1422. doi:10.1007/s00586-013-2715-7 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Ozaki T, Halm H, Hillmann A, Blasius S, Winkelmann W (1999) Aneurysmal bone cysts of the spine. Arch Orthop Trauma Surg 119:159–162CrossRefPubMedGoogle Scholar
  10. 10.
    Turker RJ, Mardjetko S, Lubicky J (1998) Aneurysmal bone cysts of the spine: excision and stabilization. J Pediatr Orthop 18:209–213PubMedGoogle Scholar
  11. 11.
    Liu JK, Brockmeyer DL, Dailey AT, Schmidt MH (2003) Surgical management of aneurysmal bone cysts of the spine. Neurosurg Focus 15:E4PubMedGoogle Scholar
  12. 12.
    Cugati G, Pande A, Jain PK, Symss NP, Ramamurthi R, Vasudevan CM (2015) Aneurysmal bone cyst of the lumbar spine. Asian J Neurosurg 10:216–218. doi:10.4103/1793-5482.161179 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Basu S, Patel DR, Dhakal G, Sarangi T (2016) Results of cement augmentation and curettage in aneurysmal bone cyst of spine. Indian J Orthop 50:99–102. doi:10.4103/0019-5413.173523 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Guarnieri G, Vassallo P, Muto M, Muto M (2014) Percutaneous treatment of symptomatic aneurysmal bone cyst of L5 by percutaneous injection of osteoconductive material (Cerament). J Neurointerv Surg 6:e43. doi:10.1136/neurintsurg-2013-010912.rep CrossRefPubMedGoogle Scholar
  15. 15.
    Otsuka T, Kobayashi M, Yonezawa M, Kamiyama F, Matsushita Y, Matsui N (2002) Treatment of chondroblastoma of the calcaneus with a secondary aneurysmal bone cyst using endoscopic curettage without bone grafting. Arthroscopy 18:430–435CrossRefPubMedGoogle Scholar
  16. 16.
    Innami K, Takao M, Miyamoto W, Abe S, Nishi H, Matsushita T (2011) Endoscopic surgery for young athletes with symptomatic unicameral bone cyst of the calcaneus. Am J Sports Med 39:575–581. doi:10.1177/0363546510388932 CrossRefPubMedGoogle Scholar
  17. 17.
    Komp M, Hahn P, Ozdemir S, Merk H, Kasch R, Godolias G, Ruetten S (2014) Operation of lumbar zygoapophyseal joint cysts using a full-endoscopic interlaminar and transforaminal approach: prospective 2-year results of 74 patients. Surg Innov 21:605–614. doi:10.1177/1553350614525668 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryTeikyo University Mizonokuchi HospitalKawasakiJapan
  2. 2.Department of Orthopaedic SurgeryMizuno Memorial HospitalTokyoJapan

Personalised recommendations