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Bisphosphonate therapy for spinal aneurysmal bone cysts.
Kieser, David C; Mazas, Simon; Cawley, Derek T; Fujishiro, Takashi; Tavolaro, Celeste; Boissiere, Louis; Obeid, Ibrahim; Pointillart, Vincent; Vital, Jean-Marc; Gille, Olivier.
Afiliación
  • Kieser DC; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Canterbury District Health Board, 2 Riccarton Avenue, Christchurch, 8011, New Zealand. kieserdavid@gmail.com.
  • Mazas S; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Cawley DT; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Fujishiro T; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Tavolaro C; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Boissiere L; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Obeid I; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Pointillart V; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Vital JM; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
  • Gille O; L'Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France.
Eur Spine J ; 27(4): 851-858, 2018 04.
Article en En | MEDLINE | ID: mdl-29356986
PURPOSE: To assess the efficacy of bisphosphonate therapy in the management of spinal aneurysmal bone cysts (ABCs). METHODS: A prospective study of six consecutive patients aged between 7 and 22 years with spinal ABCs treated with pamidronate (1 mg/kg) or zoledronate (4 mg). A visual analogue scale (VAS) for pain and radiological (contrast-enhanced MRI and CT scan at 3 and 6 months, then yearly X-rays) follow-up was continued for a minimum of 6 years. RESULTS: One patient with an unstable C2/3 failed to respond to a single dose of bisphosphonate and required surgical resection and stabilisation with autologous bone grafting. Another, with a thoraco-lumbar ABC, experienced progression of neurological dysfunction after one cycle of bisphosphonate and, therefore, required surgical resection and stabilisation. In all other patients pain progressively improved and was resolved after two to four cycles (VAS 7.3-0). These patients all showed reduction in peri-lesional oedema and increased ossification by 3 months. No patients have had a recurrence within the timeframe of this study. CONCLUSIONS: Bisphosphonate therapy can be used as the definitive treatment of spinal ABCs, except in patients with instability or progressive neurology, where surgical intervention is required. Clinicians should expect a patients symptoms to rapidly improve, their bone oedema to resolve by 3 months and their lesion to partially or completely ossify by 6-12 months.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de la Columna Vertebral / Columna Vertebral / Quistes Óseos Aneurismáticos / Difosfonatos / Conservadores de la Densidad Ósea Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2018 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de la Columna Vertebral / Columna Vertebral / Quistes Óseos Aneurismáticos / Difosfonatos / Conservadores de la Densidad Ósea Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2018 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Alemania