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Aneurysmal bone cyst: the role of cryosurgery as local adjuvant treatment
S P Peeters1, I C M Van der Geest, J W J de Rooy
1Department of Orthopaedic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
Background:
Aneurysmal bone cysts (ABCs) are most often treated with intralesional surgery (curettage) and additional bone grafting. There is debate on whether or not to use adjuvant therapy to decrease the local recurrence rate. This study is done to assess the outcome of curettage and cryosurgery as a treatment of ABC.
Methods:
We analyzed 80 consecutive cases of ABC treated with curettage and cryosurgery. Patients were followed minimal 24 months after surgery (average 55 months, range 24-122 months) with physical examination and radiographs. Functional outcome was evaluated using the musculoskeletal tumor society score (MSTS).
Results:
The 80 patients were all treated with curettage and cryosurgery. Additional bone grafting was used in 73 patients, osteosynthesis in 12 and spondylodesis in 1 patient. Four local recurrences were found in this study, a recurrence rate of 5%. All local recurrences were treated successfully with curettage and cryosurgery again 7-33 months after the initial surgery. Postoperative one fracture, one wound infection, and three transient nerve palsy occurred. The average MSTS score was 29.2 at follow-up.
Conclusions:
The use of cryosurgery as adjuvant therapy results in a lower local recurrence rate when compared to other publications for the treatment of ABC and excellent functional results.
