Keçeci Burçin, Küçük Levent, Isayev Alovsat, Sabah Dündar
Ege University, Faculty of Medicine, Department of Orthopedics and Traumatology, Izmir, Turkey.
Acta Orthop Traumatol Turc. 2014;48(5):500-6. doi: 10.3944/AOTT.2014.14.0020.
The aim of this study was to define the effective factors such as surgical method, age and cavity filling materials on local recurrence in the treatment of aneurysmal bone cysts.
The study included 85 patients (mean age: 17.9 years) that received surgical treatment for primary aneurysmal bone cyst. Nine were treated with cyst excision and 76 with intralesional curettage. The intralesional curettage group was divided into 3 subgroups according to adjuvant therapies applied; the first group received no additional adjuvant therapy, the second group received additional high-speed burr and the third group received additional high-speed burr and alcohol/phenol adjuvant treatments. Bone graft or bone cement was used to fill in the cavity. Mean follow-up period was 107.5 months. Groups were analyzed statistically in terms of local recurrence. Onset of cyst in ages under 10 and 20 years were considered a negative prognostic factor and analyzed statistically.
Local recurrence occurred in 10 (11.8%) patients. Mean duration between the initial operation and recurrence was 10 months. There was no significant difference in terms of local recurrence among the surgical treatment groups, adjuvant therapy groups, age groups and bone graft and bone cement groups.
Careful curettage of the entire cyst wall remains the most important step in the intralesional treatment of aneurysmal bone cyst.
本研究旨在确定手术方法、年龄和腔隙填充材料等有效因素对动脉瘤样骨囊肿治疗中局部复发的影响。
该研究纳入了85例接受原发性动脉瘤样骨囊肿手术治疗的患者（平均年龄：17.9岁）。9例接受囊肿切除术，76例接受病灶内刮除术。病灶内刮除术组根据所应用的辅助治疗分为3个亚组；第一组未接受额外的辅助治疗，第二组接受额外的高速磨钻治疗，第三组接受额外的高速磨钻及酒精/苯酚辅助治疗。采用骨移植或骨水泥填充腔隙。平均随访期为107.5个月。对各组的局部复发情况进行统计学分析。将10岁以下和20岁以下发病的囊肿视为不良预后因素并进行统计学分析。
10例（11.8%）患者出现局部复发。初次手术至复发的平均时间为10个月。手术治疗组、辅助治疗组、年龄组以及骨移植和骨水泥组之间在局部复发方面无显著差异。
在动脉瘤样骨囊肿的病灶内治疗中，仔细刮除整个囊肿壁仍然是最重要的步骤。
