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Vol. 21. Issue 3.
Pages 240-244 (January 2010)
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Vol. 21. Issue 3.
Pages 240-244 (January 2010)
Descompresión medular e instrumentación en un caso de variante sólida de quiste óseo aneurismático en raquis lumbar
Spine cord descompresion and instrumentation in a case of solid aneurysmal bone cyst in the lumbar spine
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A.A. Díaz-Martín
Corresponding author
aureliodiazm@yahoo.es

Correspondencia: Servicio de Cirugía. Ortopédica y Traumatología. Hospital Costa del Sol. Ctra. Nacional 340, Km. 187. 29670 Marbella. Málaga.
, N. Guerrero-Moyano, E. Guerado-Parra
Hospital Costa del Sol. Marbella
J.A. Quesada-Rubio*
* Hospital Niño Jesús. Madrid
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Resumen

Se discute el caso de un paciente varón de ocho años de edad que refería dolor y limitación funcional en extremidad inferior izquierda. Tras estudios complementarios mediante radiografías, tomografía axial computarizada, resonancia magnética y gammagrafía se evidenció la presencia de una lesión osteolítica en cuerpo y arco posterior de la tercera vértebra lumbar. La tumoración fue resecada a través de doble abordaje (anterior retroperitoneal y posterior) e instrumentación pedicular posterior con aporte estructural de hueso tricortical liofilizado en un solo tiempo. El diagnóstico histológico reveló la presencia de variante sólida de un quiste óseo aneurismático. Cinco años tras la cirugía el paciente no presentó dolor lumbar ni recurrencia de la enfermedad. La resección completa del tumor junto con instrumentación pedicular previno recidivas y desarrollo de inestabilidad.

Palabras clave:
Columna lumbar
Quiste óseo aneurismático
Artrodesis lumbar
Abreviaturas:
RM
TC
Tc-99
Summary

We report a 8-year-old boy with two month history of pain and stiffness in his left lower extremity. On xray, MRI and scintigraphy examinations a lytic lesion affecting the body and posterior arc of his third lumbar vertebral become evident. The tumour was excised through a double, anterior and posterior approach; spinal fusion with posterior transpedicular instrumentation was also performed in the same procedure; in order to achieve solid fusion tricortical liofilized graft was also inserted. Histological studies evidenced finding compatible with aneurismal bone cyst solid variant. Five years after surgery the patient is pain free and no recurrence is evident under diagnostic images tools. For the treatment of aneurismal bone cyst of the spine we recommend complete excision of the tumour in a combined anterior and posterior one staged procedure, together with hardware instrumentation and bone graft, no recurrence or instability is seen after five years follow-up.

Key words:
Lumbar spine
Aneurysmal bone cyst
Spinal stabilization

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