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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2024, Number 3

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Cir Columna 2024; 2 (3)

Thoracic aneurysmal bone cyst, decompression by costotransversectomy, corpectomy and expandable telescopic cage. Case report and literature review

Ortíz-Guillén K, García-De RJM, García E, Vargas-Oviedo A

Language: Spanish
References: 12
Page: 188-193
PDF size: 447.01 Kb.


ABSTRACT

Aneurysmal bone cysts (AOC) are benign vascularized neoplasms, however, they can show aggressive and expansive behavior. A 13-year-old woman presents with predominantly nocturnal back pain that has been going on for a month. Upon admission, a 3/5 paraparesis was confirmed in the left L3-S1 myotomes and 4/5 in the right, +++/++++ reflexes in the patellar and bilateral Achilles, a decrease in thermoalgesic sensitivity from L2 to the distal, predominantly on the left. The thoraco-lumbar tomography showed a lesion in the T12 vertebral body and posterior elements on the left side with an expansive, lytic appearance, with a trabeculated interior. The MRI s/c showed extradural, heterogeneous, with a multilocular portion with fluid-fluid levels observed to be hyperintense on T2. She underwent surgery through a left costotransversectomy, T12 corpectomy and lesion resection. The cage was inserted, its telescopic portion placed caudally avoiding stretching of the inferior nerve root as it expanded. Subsequently, fixation of T10-L2 was performed with sublaminar hooks. During the 12-month follow-up, she showed a recovery of sensitivity and strength in his lower limbs bilaterally to 4+/5. The treatment of choice in these cases is complete surgical resection and stabilization.


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