title: Advance in the treatment of aneurysmal bone cyst of the sacrum.
abstract: OBJECTIVE
  The objective of this study was the review of 11 patients with two different treatment methods used historically for aneurysmal bone cyst in the sacrum. The outcome of both procedures is reported. In addition, the treatment technique of CT-guided percutaneous injections of demineralized bone matrix mixed with bone marrow concentrate is described.
  
  
  METHODS
  From 1997 to 2008, 11 patients with sacral aneurysmal bone cyst were treated at the Rizzoli Institute, Bologna, Italy. The first seven patients had surgical curettage without bone grafting, chemical adjuvants, or arterial embolization. The last four patients had arterial embolization. The last patient did not respond to arterial embolization and was treated by CT-guided injection of demineralized bone matrix mixed with bone marrow concentrate.
  
  
  RESULTS
  Curettage was successful in five out of seven patients. Two patients suffered complications, and two cases had recurrence. Arterial embolization was successful in three of four patients. The patient treated with injection had a good clinical and radiographic result.
  
  
  CONCLUSIONS
  Both surgical and arterial embolization are effective for aneurysmal bone cyst in the sacrum. However, these treatments may lead to complications and recurrence. The use of CT-guided injections of demineralized bone matrix mixed with bone marrow concentrate may be a safe and effective alternative for treatment of these destructive and problematic lesions.
authors.affiliation: II Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy. davide.donati@ior.it
authors.forename: Davide
authors.initials: D
authors.lastname: Donati
authors.forename: Tommaso
authors.initials: T
authors.lastname: Frisoni
authors.forename: Barbara
authors.initials: B
authors.lastname: Dozza
authors.forename: Henry
authors.initials: H
authors.lastname: DeGroot
authors.forename: Ugo
authors.initials: U
authors.lastname: Albisinni
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
mesh_terms: D000293:Adolescent; D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000000981:diagnostic imaging / Q000628:therapy*; D001857:Bone Matrix / Q000637:transplantation; D001861:Bone Regeneration; D002648:Child; D003475:Curettage; D004621:Embolization, Therapeutic; D006801:Humans; D007267:Injections; D008875:Middle Aged; D011859:Radiography; D012447:Sacrum / Q000000981:diagnostic imaging; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult