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Polidocanol Sclerotherapy Plus Adjuvant Autogenous Bone Marrow Injection for Management of Aneurysmal Bone Cyst: A
Ehab Abdelfattah Elshal1, Maysra Abdelhalim Mohamed Byoumy1, Abdallah Mousa Elwany Hassan1
1Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Purpose:
Aneurysmal bone cysts (ABCs) are benign bone lesions that exhibit localized destructive growth. Conventionally, most patients are treated with curettage and bone grafting. Alternatively, percutaneous treatment using selective arterial embolization and sclerotherapy had been successfully used with promising results. Adjuvant use of bone marrow injection alone or with other agents for treatment of bone cysts was previously used. The aim of this work is to assess the clinical outcome of polidocanol sclerotherapy with adjuvant autogenous bone marrow injection for management of ABCs.
Methods:
The present prospective study was conducted on 20 patients with ABCs diagnosed on the basis of clinical and radiological findings. All patients were managed using polidocanol sclerotherapy followed by adjuvant autogenous bone marrow injection. Pain was evaluated using Visual Analog Scale (VAS). Radiographic evaluation was performed using plain radiographs. All patients were followed for 30 months after the last treatment session.
Results:
The present study was conducted on 20 patients with an age of 10.2 ± 4.4 years (range: 3.0-20.0 years). They comprised 12 males and 8 females. VAS for pain improved from 6.2 ± 1.4 at baseline to 0.3 ± 0.5 (p < 0.001) at the end of follow-up. Radiologically, cyst volume significantly decreased from 79.9 ± 26.3 ml to 2.0 ± 2.1 ml (p < 0.001). Reported complications included recurrence (5.0%), ecchymosis (10.0%), and nausea and vomiting (5.0%).
Conclusion:
Use of polidocanol sclerotherapy followed by adjuvant autogenous bone marrow injection for management of ABCs is highly effective with adequate safety profile.
