An aneurysmal bone cyst ruptured and compressed the spinal cord: a case report

Spinal aneurysmal bone cyst (ABC) is a rare benign bone lesion with various prognosis. Common clinical symptoms of spinal ABCs include local pain, swelling. But we presented a case of a teenager girl who exhibited symptoms of acute thoracic cord compression after a slight trauma and was then diagnosed with ABC in her thoracic spine. A unique aspect is that this patient did not have symptoms before she fell down on her hip, and had an acute worsening of her neurological deficits. In the vast majority of cases, for a teenager, the trauma on the spine is tiny after falling down on the hips. That is the reason we initially felt confused before she had an urgent CT scan. In order to achieve early decompression of the thoracic cord and stabilization of the local spine around T4, we proceeded with urgent lesion resection and pedicle screws fixation from T2 to T5 to remove the liquid containing cyst and achieve spinal stability. Postoperative pathology indicated the lesion was an ABC. The patient gained good neurological recovery without any adverse effect in the final follow-up. We believe spinal ABC of teenagers can have no symptoms until a slight trauma leading to acute neurological deficits. Careful preparing for emergency surgery, prompt resection of the lesion as well as spinal stability reconstruction can promote good recovery and minimal adverse effect.