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Aneurysmal bone cyst of the spine treated by concentrated bone marrow: clinical cases and review of the literature

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Abstract

Purpose

ABC is a benign lesion with unpredictable behavior. Its treatment is challenging, especially in poorly accessible surgical areas, such as spine and pelvis. Currently, the first-line treatment of ABC is repeated selective arterial embolization (SAE) until healing. Other options have been used with variable success rates. We propose an alternative treatment for spine aneurysmal bone cyst (sABC) based on the injection of concentrated autologous bone marrow.

Methods

We retrospectively report and analyze here two cases of patients, a 14-year-old girl and a 16-year-old boy, both affected by ABC in C2 vertebra which were impossible to treat by SAE. They were treated with single or repeated injection of concentrated autologous bone marrow into the lesion. Their follow-up period is 27 months for both patients.

Results

In the two cases reported here we observed a progressive ossification of the lesion, which was slow in one case, requiring three subsequent injections of concentrated bone marrow, and fast in the other case, beginning 1 month after the procedure. In both cases, the healing of the lesion was associated with symptom relief and the clinical status of the patients remains stable after 2 years.

Conclusions

Although SAE can still be considered the first line in the treatment of ABC in the axial skeleton, new promising therapeutic procedures involving the use of mesenchymal stem cells are developing.

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Acknowledgements

The authors thank Mr. Carlo Piovani for his helpful collaboration in patients’ images storage and editing and Dr. Cristiana Griffoni for collaboration in the manuscript editing.

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Authors and Affiliations

  1. Department of Oncological and Degenerative Spine Surgery, Istituto Ortopedico Rizzoli, Via G.C. Pupilli, 40136, Bologna, Italy

    Giovanni Barbanti-Brodano, Marco Girolami, Riccardo Ghermandi, Silvia Terzi, Alessandro Gasbarrini, Stefano Bandiera & Stefano Boriani

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  1. Giovanni Barbanti-Brodano
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  2. Marco Girolami
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  6. Stefano Bandiera
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  7. Stefano Boriani
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Correspondence to Giovanni Barbanti-Brodano.

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All procedures were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Considering this is a retrospective study, formal consent is not required.

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Barbanti-Brodano, G., Girolami, M., Ghermandi, R. et al. Aneurysmal bone cyst of the spine treated by concentrated bone marrow: clinical cases and review of the literature. Eur Spine J 26 (Suppl 1), 158–166 (2017). https://doi.org/10.1007/s00586-017-4978-x

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  • DOI: https://doi.org/10.1007/s00586-017-4978-x

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