Aneurysmal bone cyst of the spine: Report of four cases and review of the literature

Abstract

Purpose: We report four cases of spinal Aneurysmal bone cyst (ABC) that were managed surgically at King Fahad Specialist Hospital in Dammam, Saudi Arabia. This report aims to describe the clinical features and the need for surgical excision preceded by embolization in spinal ABC. Method: A retrospective review of the OR list and tumor board records between 2013 and 2016 yielded a total of 4 cases of spinal ABC who were surgically treated at KFSH-D. Their clinical presentations, radiological and pathological features are reviewed along with the surgical intervention utilized and its outcome. Results: Total of 4 cases were identified, all of them were female (100%). The age ranged from 13 to 25 years old (mean age = 17.75). Two cases (50%) were located in the thoracic spine, one (25%) cervical and one (25%) in the lumbar spine. Back pain, unsteady gait, and progressive limb weakness were the most common presenting symptoms. All the cases underwent embolization followed by surgical excision and fixation with a variable degree of improvement postoperatively. Conclusion: Spinal ABC is a benign tumor that can present with a wide variety of non-specific symptoms. Pre-operative embolization can be helpful to reduce bleeding during surgery. Surgical decompression can lead to significant improvement even in case of severe neurological deficit. Radiation therapy can be used as an adjunct treatment in selected cases.