title: Percutaneous treatment of symptomatic aneurysmal bone cyst of L5 by percutaneous injection of osteoconductive material (Cerament).
abstract: We present a case report of a 33-year-old woman with back pain for several months which was resistant to medical treatment. Thoracolumbar MRI and multidetector CT showed an aneurysmal bone cyst intersecting the body and pedicles of L5. Minimally invasive treatment was performed with percutaneous injection of osteoconductive cement (Cerament) to induce sclerosis and bone remodeling of the bone cyst lesion with an analgesic effect. Before treatment, spinal angiography was performed to exclude arterial afferents. No bone biopsy was done. Under general anesthesia and fluoroscopic guidance, a first vertebroplasty was performed by a bilateral transpedicular approach using the osteoconductive cement followed 2 months later by a second treatment with CT-fluoro-guided direct injection of Cerament. No complications occurred during the procedure. At 4 and 6 months follow-up the MRI/CT showed sclerotic bone remodeling of the walls of the aneurysmal cyst with clinical improvement.
authors.affiliation: Neuroradiology Service, Cardarelli Hospital, Naples, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Guarnieri
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vassallo
authors.forename: Massimo
authors.initials: M
authors.lastname: Muto
authors.forename: Mario
authors.initials: M
authors.lastname: Muto
mesh_terms: D000328:Adult; D001843:Bone Cements / Q000627:therapeutic use; D017824:Bone Cysts, Aneurysmal / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D002133:Calcium Sulfate / Q000627:therapeutic use*; D004338:Drug Combinations; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007278:Injections, Spinal; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008159:Lumbar Vertebrae; D018810:Magnetic Resonance Angiography / Q000379:methods; D061330:Multidetector Computed Tomography / Q000379:methods; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010148:Intractable Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D004338:Drug Combinations; C582328:cerament; D017886:Durapatite; D002133:Calcium Sulfate
keywords: CT; Intervention; Spine; Technique; Tumor