Removal of aneurysmal bone cyst in the area of C1, C2 and foramen magnum. Follow-up of surgical osteoplastic repair by means of 3 D CT studies 15 years later.

First, the author relates his memories of his first encounter with the new Editor-in-Chief of the Acta Neurochirurgica in 1957 and the reasons why it made such an unforgettable impression. Next, follows a discussion of the technical difficulties in the treatment of spinal aneurysmal bone cysts, which may produce extensive destruction of its bony elements. The relatively rare occurrence of these lesions and resulting limited experience provide insufficient grounds for developing rigid rules of surgical treatment. Their treatment must rather rely on experience by means of examples (paradigms). The present author's principles of surgical strategy are total removal of these cysts and repair by means of stabilizing bony autotransplants. A description is given of an unusual case of an aneurysmal bone cyst localized in the cervical-occipital transition area in which 3 D CT images give a better view on stabilization reached by osteoplastic repair of the destroyed structures than can be achieved with previous imaging methods.