Advertisement

Symptomatic aneurysmal bone cysts of the spine: clinical features, surgical outcomes, and prognostic factors

  • Yuechao Zhao
  • Shaohui He
  • Haitao Sun
  • Xiaopan Cai
  • Xin Gao
  • Peng Wang
  • Haifeng WeiEmail author
  • Wei XuEmail author
  • Jianru XiaoEmail author
Original Article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Aneurysmal bone cyst En bloc Prognosis Disease-free survival Recurrence 

Notes

Acknowledgements

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.

Supplementary material

586_2019_5920_MOESM1_ESM.pptx (596 kb)
Supplementary material 1 (PPTX 596 kb)

References

  1. 1.
    Novais EN, Rose PS, Yaszemski MJ, Sim FH (2011) Aneurysmal bone cyst of the cervical spine in children. J Bone Joint Surg Am 93:1534–1543CrossRefPubMedGoogle Scholar
  2. 2.
    Taylor FW (1956) Aneurysmal bone cyst; a report of three cases. J Bone Joint Surg Br 38-B:293–300CrossRefPubMedGoogle 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.
    Boriani S, De Iure F, Campanacci L, Gasbarrini A, Bandiera S, Biagini R et al (2001) Aneurysmal bone cyst of the mobile spine: report on 41 cases. Spine (Phila Pa 1976) 26:27–35CrossRefGoogle Scholar
  5. 5.
    Bertoni F, Bacchini P, Capanna R, Ruggieri P, Biagini R, Ferruzzi A et al (1993) Solid variant of aneurysmal bone cyst. Cancer 71:729–734CrossRefPubMedGoogle Scholar
  6. 6.
    Guibaud L, Herbreteau D, Dubois J, Stempfle N, Berard J, Pracros JP et al (1998) Aneurysmal bone cysts: percutaneous embolization with an alcoholic solution of zein–series of 18 cases. Radiology 208:369–373CrossRefPubMedGoogle Scholar
  7. 7.
    Capanna R, Albisinni U, Picci P, Calderoni P, Campanacci M, Springfield DS (1985) Aneurysmal bone cyst of the spine. J Bone Joint Surg Am 67:527–531CrossRefPubMedGoogle Scholar
  8. 8.
    Papagelopoulos PJ, Currier BL, Shaughnessy WJ, Sim FH, Ebsersold MJ, Bond JR et al (1998) Aneurysmal bone cyst of the spine. Management and outcome. Spine (Phila Pa 1976) 23:621–628CrossRefGoogle Scholar
  9. 9.
    Hay MC, Paterson D, Taylor TK (1978) Aneurysmal bone cysts of the spine. J Bone Joint Surg Br 60-B:406–411CrossRefPubMedGoogle Scholar
  10. 10.
    Zileli M, Isik HS, Ogut FE, Is M, Cagli S, Calli C (2013) Aneurysmal bone cysts of the spine. Eur Spine J 22:593–601CrossRefPubMedGoogle Scholar
  11. 11.
    Schaffer L, Kranzler LI, Siqueira EB (1985) Aneurysmal bone cyst of the spine. A case report. Spine (Phila Pa 1976) 10:390–393CrossRefGoogle Scholar
  12. 12.
    Mohan V, Arora MM, Gupta RP, Izzat F (1989) Aneurysmal bone cysts of the dorsal spine. Arch Orthop Trauma Surg 108:390–393CrossRefPubMedGoogle Scholar
  13. 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. 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. 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 7:179–192PubMedGoogle Scholar
  16. 16.
    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 (Phila Pa 1976) 35:E1221–E1229CrossRefGoogle Scholar
  17. 17.
    Enneking WF (1986) A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res (204):9–24Google Scholar
  18. 18.
    Boriani S, Weinstein JN, Biagini R (1997) Primary bone tumors of the spine. Terminology and surgical staging. Spine (Phila Pa 1976) 22:1036–1044CrossRefGoogle Scholar
  19. 19.
    Campanacci M (1990) Aneurysmal bone cyst. In: Campanacci M (ed) Bone and soft tissue tumors. Springer, New York, pp 725–751CrossRefGoogle Scholar
  20. 20.
    Szendroi M, Cser I, Konya A, Renyi-Vamos A (1992) Aneurysmal bone cyst. A review of 52 primary and 16 secondary cases. Arch Orthop Trauma Surg 111:318–322CrossRefPubMedGoogle Scholar
  21. 21.
    Rajasekaran S, Aiyer SN, Shetty AP, Kanna R, Maheswaran A (2019) Aneurysmal bone cyst of C2 treated with novel anterior reconstruction and stabilization. Eur Spine J 28(2):270–278CrossRefPubMedGoogle Scholar
  22. 22.
    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 27:368–374CrossRefPubMedGoogle Scholar
  23. 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 2:341–353PubMedGoogle Scholar
  24. 24.
    Lichtenstein L (1957) Aneurysmal bone cyst; observations on fifty cases. J Bone Joint Surg Am 39-A:873–882CrossRefPubMedGoogle Scholar
  25. 25.
    Ruiter DJ, van Rijssel TG, van der Velde EA (1977) Aneurysmal bone cysts: a clinicopathological study of 105 cases. Cancer 39:2231–2239CrossRefPubMedGoogle Scholar
  26. 26.
    Watanabe A, Araki K, Hirai K, Kubo N, Igarashi T, Tsukagoshi M et al (2016) A novel clinical factor, D-dimer platelet multiplication, may predict postoperative recurrence and prognosis for patients with cholangiocarcinoma. Ann Surg Oncol 23:886–891CrossRefPubMedGoogle Scholar
  27. 27.
    Watanabe A, Araki K, Harimoto N, Kubo N, Igarashi T, Ishii N et al (2018) D-dimer predicts postoperative recurrence and prognosis in patients with liver metastasis of colorectal cancer. Int J Clin Oncol 23:689–697CrossRefPubMedGoogle Scholar
  28. 28.
    Liu Z, Guo H, Gao F, Shan Q, Li J, Xie H et al (2017) Fibrinogen and D-dimer levels elevate in advanced hepatocellular carcinoma: high pretreatment fibrinogen levels predict poor outcomes. Hepatol Res 47:1108–1117CrossRefPubMedGoogle Scholar
  29. 29.
    Amendola L, Simonetti L, Simoes CE, Bandiera S, De Iure F, Boriani S (2013) Aneurysmal bone cyst of the mobile spine: the therapeutic role of embolization. Eur Spine J 22:533–541CrossRefPubMedGoogle Scholar
  30. 30.
    Benzil DL, Saboori M, Mogilner AY, Rocchio R, Moorthy CR (2004) Safety and efficacy of stereotactic radiosurgery for tumors of the spine. J Neurosurg 101(Suppl 3):413–418CrossRefPubMedGoogle Scholar
  31. 31.
    Bilsky MH, Yamada Y, Yenice KM, Lovelock M, Hunt M, Gutin PH et al (2004) Intensity-modulated stereotactic radiotherapy of paraspinal tumors: a preliminary report. Neurosurgery 54:823–830 (discussion 821–830) CrossRefPubMedGoogle Scholar
  32. 32.
    Kieser DC, Mazas S, Cawley DT, Fujishiro T, Tavolaro C, Boissiere L et al (2018) Bisphosphonate therapy for spinal aneurysmal bone cysts. Eur Spine J 27:851–858CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Oncology, Changzheng HospitalSecondary Military Medical UniversityShanghaiChina
  2. 2.Department of Radiology, Changzheng HospitalSecondary Military Medical UniversityShanghaiChina

Personalised recommendations