Percutaneous Doxycycline Foam Injections: Novel Treatment Method for Vertebral Aneurysmal Bone Cysts

Aneurysmal bone cysts (ABCs) are among the most aggressive benign bone tumors, often occurring in both long bones and the spine. Treatment remains controversial as recurrence rates continue to be high. Treatment options include curettage with or without bone grafting, arterial embolization, en block resection with or without instrumentation or arthrodesis, radiation, and intralesional drug injections (steroids, calcitonin, doxycycline). We present the case of a patient with a thoracic vertebral ABC who underwent 2 rounds of doxycycline foam percutaneous injections. At the 1-year follow up appointment, all symptoms had been resolved. Repeat computed tomography and magnetic resonance imaging demonstrated that the ABC had nearly filled in completely with new bone. Our case demonstrates successful use of this percutaneous, less invasive method in the management of vertebral ABCs.