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DOI: 10.1055/s-0045-1809959
Aneurysmal Bone Cyst Presenting with Neurological Deficit: Two Cases Reports and Review of the Literature
Cisto ósseo aneurismático com déficit neurológico: Relato de dois casos e revisão da literatura
Abstract
Aneurysmal bone cysts are rare, benign, hypervascular lesions, locally destructive due to their progressive growth. The severity of symptoms depends on the degree of associated spinal cord injury. The surgical approach is the main treatment method and aims at complete tumor resection with reconstruction and/or stabilization of the spine. The goal of this study is to present the authors' experience with surgical treatment of aneurysmal bone cysts of the thoracolumbar spine in the pediatric population and describe the treatment in the context of literature. Two patients of the authors and reports in the literature were identified and analyzed. A 16-year-old female presented with acute spinal cord syndrome classified as ASIA A due to thoracic cord compression. The second patient is an 8-year-old male admitted with left leg weakness due to compression of lumbar roots. Both patients underwent complete tumor resection with corpectomy, reconstruction of the anterior spine with body cage, and stabilization of the posterior spine with pedicular screws. After 6 months of surgery, they evolved with significant improvement in motor strength. Even at severe clinical presentation, the patient with an aneurysmal bone cyst may improve neurological deficits if treated in a timely manner, with tumor resection, spinal cord and/or nerve decompression, spinal reconstruction, and postoperative rehabilitation.
Resumo
Os cistos ósseos aneurismáticos são lesões raras, benignas e hipervasculares, localmente destrutivas devido ao seu crescimento progressivo. A gravidade dos sintomas depende do grau de lesão da medula espinhal associada. A abordagem cirúrgica é o principal método de tratamento e visa à ressecção completa do tumor com reconstrução e/ou estabilização da coluna vertebral. O objetivo deste estudo é apresentar a experiência dos autores com o tratamento cirúrgico de cistos ósseos aneurismáticos da coluna toracolombar na população pediátrica e descrever o tratamento no contexto da literatura. Dois pacientes dos autores e relatos na literatura foram identificados e analisados. Uma adolescente, de sexo feminino, de 16 anos apresentou síndrome medular aguda classificada como ASIA A devido à compressão da medula torácica. O segundo paciente é uma criança, do sexo masculino, de 8 anos de idade, admitido com fraqueza na perna esquerda devido à compressão das raízes lombares. Ambos os pacientes foram submetidos à ressecção completa do tumor com corpectomia, reconstrução da coluna anterior com body cage e estabilização da coluna posterior com parafusos pediculares. Após 6 meses da cirurgia, evoluíram com melhora significativa da força motora. Mesmo com quadro clínico grave, o paciente com cisto ósseo aneurismático pode melhorar os déficits neurológicos se tratado em tempo hábil, com ressecção do tumor, descompressão da medula espinhal e/ou nervos, reconstrução da coluna e reabilitação pós-operatória.
Publication History
Received: 03 May 2023
Accepted: 20 March 2025
Article published online:
16 July 2025
© 2025. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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