Portal de Periódicos da CAPES

Is Sclerotherapy Better than Intralesional Excision for Treating Aneurysmal Bone Cysts?

2009; Lippincott Williams & Wilkins; Volume: 468; Issue: 6 Linguagem: Inglês

10.1007/s11999-009-1144-8

1528-1132

Manish Kumar Varshney, Shishir Rastogi, Shah Alam Khan, Vivek Trikha,

Sarcoma Diagnosis and Treatment

Background Minimally invasive approaches such as sclerotherapy have been introduced to treat aneurysmal bone cysts. Sclerotherapy has been associated with reasonable healing rates during the past two decades. However, it is unclear whether sclerotherapy compares with the more traditional extended curettage and bone grafting. Questions/purposes We therefore compared the healing rates and functional scores in patients having percutaneous repetitive sclerotherapy using polidocanol (Group 1) with those with intralesional excision (extended curettage with a high-speed burr) and bone grafting (Group 2) for treatment of aneurysmal bone cyst. Patients and Methods We randomly divided 94 patients into two treatment groups. We assessed healing rates (primary outcome measure), pain relief, time to healing and recurrence, hospital stay, and the Enneking functional score. Forty-five patients from Group 1 and 46 from Group 2 were available for study. The minimum followup was 3.2 years (mean, 4.4 years; range, 3.2-6.1 years). Results At last followup, 93.3% in Group 1 and 84.8% in Group 2 had achieved healing. Complications in Group 1 were minor and resolved. In Group 2, three patients had deep infections and five had superficial infections, and two had growth disturbances. Although the healing rates were similar, we found higher rates of clinically important complications, worse functional outcomes, and higher hospital burden associated with intralesional excision. Conclusions Repetitive sclerotherapy using polidocanol is a minimally invasive, safer method of treatment for aneurysmal bone cysts compared with intralesional excision and bone grafting. In this preliminary study, we found similar recurrence rates for the two treatment methods, however, this will require confirmation in larger studies. Level of Evidence Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.