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

  • 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
Original Article
  • 68 Downloads

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.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Spinal tumor Aneurysmal bone cyst Percutaneous doxycycline treatment Open surgery Recurrence 

Notes

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).

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.

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”.

Supplementary material

586_2018_5836_MOESM1_ESM.pptx (12.5 mb)
Supplementary material 1 (PPTX 12801 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OrthopaedicsPeking University Third HospitalBeijingChina
  2. 2.Department of RadiologyPeking University Third HospitalBeijingChina
  3. 3.Peking University Health Science CenterBeijingChina
  4. 4.Department of PathologyPeking University Health Science CenterBeijingChina
  5. 5.Department of Interventional Radiology and Vascular SurgeryPeking University Third HospitalBeijingChina

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