Clinic of Orthopaedic and Traumatology, Polish Mother's Memorial Hospital Research Institute, Lodz 93-338, Poland.
World J Surg Oncol. 2013 May 23;11:109. doi: 10.1186/1477-7819-11-109.
The recurrence rate after aneurysmal bone cyst (ABC) treatment is quite high despite its benign nature. In ABC therapy, curettage is the treatment of choice; en bloc excision results in a lower recurrence rate, but more extensive reconstructive surgery is needed with associated morbidity. The aim of the present study was to compare the outcomes of the two treatment options.
A retrospective analysis was performed on 26 patients treated for ABCs: 16 by curettage and 10 by en bloc excision. Each lesion was classified according to Enneking and patients were followed up for a mean time of 9.2 years. On follow-up, radiological examination and functional assessment (range of motion, muscle strength) were performed. Recurrence was defined as the presence of an osteolytic lesion, especially one with a tendency to grow.
On follow-up, the following symptoms were more prevalent in the en bloc excision group compared to the curettage group: pain (en bloc 20% versus curettage 6.25%), limb length differences (en bloc 20% versus curettage 12.5%), reduced range of motion (en bloc 20% versus curettage 6.25%) and muscle strength impairment (en bloc 50% versus curettage 31.2%); however, the differences were not statistically significant (P >0.05). In the curettage group, two cases of postoperative complications and two cases of recurrence were seen, while in the en bloc excision group one case of complications was noted.
Curettage is a standard procedure in ABC management. En bloc excision is another option, albeit more technically demanding, that may be considered in recurrent lesions with extensive bone destruction or for cysts in an expendable location.
尽管动脉瘤样骨囊肿（ABC）为良性病变，但治疗后复发率仍较高。在 ABC 的治疗中，刮除术是首选治疗方法；整块切除可降低复发率，但需要进行更多的广泛重建手术，相关发病率也更高。本研究旨在比较这两种治疗选择的结果。
对 26 例 ABC 患者进行回顾性分析：16 例采用刮除术，10 例采用整块切除术。根据 Enneking 对每个病变进行分类，并对患者进行平均 9.2 年的随访。随访时进行影像学检查和功能评估（活动范围、肌肉力量）。复发定义为存在溶骨性病变，尤其是有生长趋势的病变。
在随访时，整块切除组比刮除组更常见以下症状：疼痛（整块切除组 20%，刮除组 6.25%）、肢体长度差异（整块切除组 20%，刮除组 12.5%）、活动范围减小（整块切除组 20%，刮除组 6.25%）和肌肉力量减弱（整块切除组 50%，刮除组 31.2%）；但差异无统计学意义（P＞0.05）。在刮除组中，有 2 例术后并发症和 2 例复发，整块切除组中有 1 例并发症。
刮除术是 ABC 管理的标准程序。整块切除术是另一种选择，尽管技术要求更高，但对于广泛骨破坏的复发性病变或在可牺牲部位的囊肿，也可以考虑使用。
