title: Aneurysmal bone cyst of the mobile spine: the therapeutic role of embolization.
abstract: OBJECTIVE
  Our aim is to define the role of embolization in the treatment of aneurysmal bone cyst of the spine in order to include this option in the decision making process.
  
  
  METHODS
  From April 2004 to November 2009, seven patients with primary aneurysmal bone cyst of the mobile spine treated by embolization have been prospectively followed-up. All clinical presentations and imagings were recorded. There are many options of embolic agent and techniques used, but all aim to devascularize the tumor. The therapeutic protocol includes: embolization repeated every 8 weeks until the appearance of radiographic signs of healing. Complications, rate of healing and clinical outcome were analyzed.
  
  
  RESULTS
  The number of embolizations varied from one to a maximum of seven without related intra- or post-operative complications. One patient, after four selective arterial embolizations, underwent direct percutaneous injection of embolic agents into the cyst. A clinical and radiographical response was achieved in all patients who were found alive and completely free of disease at mean follow-up of 46 months after last treatment and nobody crossed to surgical option.
  
  
  CONCLUSIONS
  Embolization seems to be the first option for spinal aneurysmal bone cyst treatment because of the best cost-to-benefit ratio. It is indicated in intact aneurysmal bone cyst, when diagnosis is certain, when technically feasible and safe and when no pathologic fracture or neurologic involvements are found. If embolization fails, other options for treatment would still be available.
authors.affiliation: Department of Orthopedics and Traumatology, Spine Surgery, Maggiore Hospital, 'C. A. Pizzardi', Largo Nigrisoli 1, 40100 Bologna, Italy. luca.amendola@yahoo.it
authors.forename: L
authors.initials: L
authors.lastname: Amendola
authors.forename: L
authors.initials: L
authors.lastname: Simonetti
authors.forename: C E
authors.initials: CE
authors.lastname: Simoes
authors.forename: S
authors.initials: S
authors.lastname: Bandiera
authors.forename: F
authors.initials: F
authors.lastname: De Iure
authors.forename: S
authors.initials: S
authors.lastname: Boriani
mesh_terms: D000293:Adolescent; D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000000981:diagnostic imaging / Q000628:therapy*; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D013131:Spine / Q000000981:diagnostic imaging*; D016896:Treatment Outcome