Primary Aneurysmal Bone Cyst of the Cervical and Cervico-thoracic Regions of the Spine

Background: Primary aneurysmal bone cyst (ABC) is a locally aggressive neoplasm associated with bone destruction. The aim of this study is to present treatment options and their outcomes in ABC involving the cervical spine and the cervico-thoracic junction. Patients and Methods: Six patients with ABC of the spine were surgically treated. The cervical spine was involved in four and the cervicothoracic junction in two. The patients’ complains were recorded. Their pain was scaled on VAS. Their neurologic status was graded according to Frankel. All patients were evaluated preoperatively with plain radiographs, CT scan and MRI. The surgical approaches and stages were documented for each case. The patients were followed up for a minimum of 2 years. Any improvement in pain and neurologic status was noted. Follow up images were assessed for any construct failure or recurrence. Results: All patients presented with axial pain (VAS 5.7). Two complained of radicular pain and one of neck swelling. Three patients were neurologically intact, one was grade D and another grade C. Piecemeal tumor resection was performed. Dual approach was done with anterior corpectomy and reconstruction. This was combined with posterior intralesional curettage or resction of the affected posterior spinous elements and fixation. The mean VAS for pain improved to 2.3 at final follow up. No case showed neurologic deterioration after surgery. At final follow up, the patients with preoperative neurologic deficits showed full recovery to Frankel E. Recurrence was noted radiologically in two cases involving the posterior spinous elements.