Bone Cyst - Treatment

Unicameral cyst therapy:The decision to perform surgery on patients with unicameral bone cyst is individualized. Intro to maintain satisfactory asymptomatic lesion cortical thickness is only necessary medical observation. A lesion with cortical thinning may require surgery. Factors such as lower extremity lesion, affected more than the mechanical stress from the top and the young age of the child can keep teenagers from less powerful restraining influence surgical decision.Treatment of pathological fracture simple cause cyst resolution in 25% of cases.
Treatment includes observation, injection of corticosteroids, curettage and bone grafting, bone marrow aspirate and excised en bloc. Cyst aspiration and corticosteroid injections have become popular due to low risk of complications. Mechanism of action of corticosteroid injections is unclear. Advantages include short-term injections with methylprednisolone intervention, less bleeding and shorter recovery. Seven large radiographic lesions are factors that predispose to a poor response to therapy.
Cyst aneurysm therapy:Cysts are surgically treated aneurysms. Rarely, a cyst can be monitored clinically asymptomatic, producing minimum bone destructions. When such a patient is monitored and the diagnosis must be certain not to increase lesion size. Some anatomical locations can be difficult for the surgical approach. If such situations are encountered there are other methods of treatment such as injections and oculzia Intralesional selective pressure.Wants therapy to prevent pathological fracture, especially hip.
Curettage and bone grafting methods of treatment are historical only curettage is associated with high recurrence and complete excision with functional impotence. As adjuvant treatment modalities Cryosurgery or electric cauterization may be indicated with curettage, and complete excision reserved for recurrent cases.
Selective arterial embolization is a promising method. During angiography embolic agent is placed intro nutrient artery of the cyst. It has the advantage of addressing difficult anatomical areas, when is this glorifying functional joint subchondral bone destruction.Can be made 48 hours before surgery to relieve bleeding inteventiei.
Intralesional injection is indicated for cases with difficult surgical approach and when other methods are contraindicated. Use calcitonin and methylprednisolone. Injections combine angiostatic inhibitory effect of methylprednisolone and the fibroblast and the effect of osteoclastic bone stimulating properties of calcitonin. Are performed under CT guidance and anesthesia.
Block or wide excision is reserved for advanced tumors that can not be treated by intralesional excision. The rate of recurrence after en bloc excision is 7%. Options include reconstruction after wide excision and reconstruction with structural allogrefarea endoprosthesis or allograft prosthetic.
Adjuvant therapies may be used with liquid nitrogen and polymethylmethacrylate. They use thermal methods, chemical to determine bone necrosis. Liquid Nitrogen is the most popular method adjuvant. It is sprayed on the tube printrun cyst or injected.Phenol is used less often as a neoadjuvant. PMMA is used for thermal properties of bone necrosis forcing.
Prognosis:The prognosis is generally good. The lesion is considered to resolve spontaneously in most cases. Cases presenting to the doctor are those appearing cortical thinning and fractures. In general treatment only promotes natural healing.Stopping the growth occurs in 10% of patients. The cause is uncertain but may be the result of fractures associated with the cyst, which alters the structure of bone by curettage or by direct extension of the cyst in the Fizeau plate epiphysis.Recurrence occurs in the first year after surgery. However, patients should be regularly monitored for five years. Early detection is important to appellants, when the lesion is small and easily treated.Children should be monitored until reaching maturity to ensure the absence of interfering with deformities and bone growth. Patients receiving radiotherapy should be monitored for life because of the risk of secondary sarcoma.