Aneurysmal Bone Cyst of Spine: A Case Series

BackgroundAneurysmal bone cysts (ABCs) of the spine are rare, benign, yet locally aggressive vascular lesions that predominantly affect children and young adults. Despite their benign nature, these tumors can cause neurological deficits, spinal instability, and significant intraoperative bleeding, presenting substantial management challenges. ObjectiveTo describe the clinical presentation, surgical management, and outcomes of spinal ABCs in a single-center case series. MethodsA retrospective review was conducted on six patients with histologically confirmed spinal ABCs treated surgically between January 2022 and December 2023. Lesion characteristics, imaging findings, neurological status (ASIA score), surgical technique, and postoperative outcomes were analyzed. All patients underwent total tumor resection with spinal fusion. One case required a staged anterior–posterior approach due to tumor size and vertebral artery involvement; the remaining cases were treated via a posterior-only approach. ResultsThe cohort consisted of three males and three females (mean age: 15.8 years). Lesions were located in the lumbar (50%), cervical (40%), and thoracic (10%) regions. Two patients (33%) presented with neurological deficits. All achieved full neurological recovery postoperatively (ASIA E). Preoperative embolization was performed in one patient and was associated with the lowest intraoperative blood loss. Two minor postoperative complications occurred but were managed successfully. No local tumor recurrence was observed during a minimum follow-up of 12 months. ConclusionSurgical resection with spinal stabilization is an effective treatment for spinal ABCs, offering excellent neurological outcomes and low recurrence risk. Despite its limited sample size, this series underscores the importance of individualized surgical planning, histopathological confirmation, and multidisciplinary coordination, particularly in anatomically complex or high-risk cases.