An aneurysmal bone cyst in the cervical spine of a 10-year-old girl: a case report

Spine (Phila Pa 1976). 2006 Jun 15;31(14):E475-9. doi: 10.1097/01.brs.0000222126.91514.cb.

Abstract

Study design: An aneurysmal bone cyst in the neural arch of the fourth cervical vertebra of a 10-year-old girl is reported, along with a brief review of the literature on the topic.

Objective: To report the presentation and diagnosis of this disorder along with a discussion of the major pitfalls of treatment.

Summary of background data: An aneurysmal bone cyst occurs commonly in the second decade, with a predilection for the lumbar spine. With occurrence in the neural arch of a cervical vertebra, the potential for instability following surgical excision is high.

Methods: A 10-year-old white female presented with neck pain of 3 months' duration. Diagnostic imaging revealed an expansile lytic lesion in the spinous process and lamina of the fourth cervical vertebra. Surgical treatment consisted of excisional biopsy and a segmental instrumented posterior fusion from C3-C5. The histopathology was consistent with an aneurysmal bone cyst.

Results: Surgical excision consisting of laminectomy and instrumented segmental fusion provided a good clinical result, and minimized the risk and degree of the 2 most common complications: recurrence of the tumor; and postlaminectomy kyphosis, a frequent occurrence in the pediatric population.

Conclusions: In pediatric patients who develop a bone tumor of the posterior elements of the cervical spine, careful clinical and radiologic evaluation is necessary to narrow the differential diagnosis. In most cases, a complete excision should be performed if possible. The risk of postlaminectomy kyphosis is high in the pediatric age population. As such, a fusion should be considered whenever a laminectomy is performed in the immature cervical spine. Risk factors for kyphosis include a high cervical level, multiple laminectomy levels, and postoperative irradiation.

Publication types

  • Case Reports

MeSH terms

  • Bone Cysts, Aneurysmal / diagnosis*
  • Bone Cysts, Aneurysmal / pathology
  • Bone Cysts, Aneurysmal / surgery*
  • Bone Plates
  • Bone Screws
  • Cervical Vertebrae* / diagnostic imaging
  • Cervical Vertebrae* / pathology
  • Cervical Vertebrae* / surgery
  • Child
  • Female
  • Humans
  • Kyphosis / etiology
  • Laminectomy* / adverse effects
  • Magnetic Resonance Imaging
  • Spinal Diseases / diagnosis*
  • Spinal Diseases / pathology
  • Spinal Diseases / surgery*
  • Spinal Fusion*
  • Tomography, X-Ray Computed