Minimally Invasive Treatment of Aneurysmal Bone Cysts with Gelified Ethanol (DiscoGel®): Evaluation of Feasibility, Safety, and Efficacy.

INTRODUCTION

Aneurysmal bone cysts are locally aggressive bone lesions. The aim of this study was to evaluate safety and effectiveness of radio-opaque gelified ethanol sclerotherapy in treating primary aneurysmal bone cyst.

MATERIALS AND METHODS

In this single-center, retrospective study (January 1st, 2012, to June 30th, 2024), 32 patients with primary aneurysmal bone cysts were treated with percutaneous sclerotherapy using radio-opaque gelified ethanol at various skeletal sites. Of these, 27 patients were included in the analysis, 5 patients were excluded due to follow-up of less than 12 months. The primary outcome measure was the safety of the procedures. Secondary outcomes measures included clinical success, defined as the absence of post-sclerotherapy fractures or the need for surgical revision, and radiological success, determined by the conversion of an active or aggressive aneurysmal bone cyst to inactive, according to Campanacci's classification.

RESULTS

No major complications related to the procedure were observed. One minor complication (3.7%) was reported: One local collection resolved with antibiotic therapy. The remaining patients showed favorable clinical and radiological outcomes. No fractures were recorded after sclerotherapy. Surgical revision for progressive recurrence was necessary in 2 cases (7.4%). Aneurysmal bone cyst becoming inactive in 21 of 27 (77.8%) patients after 12 months, 13 of 14 (92.8%) patients after 24 months, and 7 of 7 (100%) and 5 of 5 (100%) patients after more than 36 and 48 months, respectively.

CONCLUSION

Radio-opaque gelified ethanol sclerotherapy offers a safe, effective, and minimally invasive treatment for primary aneurysmal bone cyst. It may be considered a first-line approach, similar to other sclerotherapy methods, potentially avoiding the need for invasive surgery as an initial treatment option.