Surgical treatment of aneurysmal bones cysts

Abstract

Introduction. Bone cysts are one of the most common tumor-like bone diseases of childhood, most often occurring in the 1st and 2nd decade of life. According to the world medical literature, there is still no consensus on the best methods of treating bone cysts.Aim – to evaluate the effectiveness of surgical treatment of aneurysmal bone cysts (ABC) in children with the use of allografts of biological (animal and human) origin.Materials and methods. This study included 56 pediatric patients with ABC treated at The National Medical Research Center for Children’s Health, Russia, Moscow. 37 patients with aneurysmal bone cysts (29 active ABC, 8 inactive ABC) underwent surgical treatment. Our follow-up period ranged from 12 months to 80 months. In the postoperative period, the examination was carried out at a period of 3, 6, 12, 18, 24 months and then once a year, while assessing: the presence/absence of the recurrence (radiologically), the timing of functional recovery of the operated segment, the timing of X-ray reconstruction of the graft, the assessment of physical and emotional components of the patients’ quality of life were evaluated using the PedsQL questionnaire at admission and within 12 months from the date of surgery.Results and discussion. In 37 cases of surgical treatment of ABC with the use of allografts of biological origin, the recurrence presented in 7 patients (19%) – these patients, who had an active ABC, required repeated surgical interventions. The average time of complete bone repair in the lesion site ranged from 9 months to 22 months (14 months on average). Functional recovery of the operated segments was on average 10 months for the upper extremities and 12 months for the lower extremities.Conclusion. The use of allografts of biological origin is effective in the case of inactive aneurysmal bone cysts. In case of active ABC the effectiveness of bone grafting with allografts of biological origin is reduced.