Abstract | OBJECTIVE: MATERIALS AND METHODS: Between July 2013 and September 2019, eight consecutive patients (5 males; 3 females; mean age 22±17, range 7-52) underwent fluoroscopic/CT-guided intraosseous sclerotherapy for sABCs. Pain and/or neurological compromise was the primary indications. Procedural data, complications, imaging, and clinical results were analyzed. RESULTS: Technical success was achieved in all cases. Mean procedure time was 25±15 min (range 6-167); 1 to 5 repeat treatment cycles (mean 3.7±1.2) utilizing a mean 2.6mls±1.3 (range 1-6) of agitated 3% STS, with a DLP mean dose of 158±91 mGy*cm (range 62-331) per procedure. One reported a minor complication ( pain), but no significant complications. Two patients had persistent neurological deficit due to cord compression despite successful sclerotherapy, requiring surgical resection (and were thereby excluded from the final outcome analysis). The remaining six patients demonstrated a significant reduction in tumor volume (p = 0.028), pain (p = 0.027), and SINS (spinal instability neoplastic score) (p = 0.027) at up to 5 years of follow-up (mean 20 ± 16.7, range 7-51 months). CONCLUSION: Percutaneous sclerotherapy with STS is a minimally invasive, technically feasible, safe, and effective first-line treatment for primary sABCs causing pain and neurological compromise, alleviating the need for extensive surgery. It is most effective with three or more treatment cycles, in patients with higher SINS, pain scores, or tumor volumes at the initial presentation.
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Authors | Danoob Dalili, Jack Parker, Arya Mirzaian, James Teh, Mark Bratby, Ramy Mansour, Jeremy Reynolds |
Journal | Skeletal radiology
(Skeletal Radiol)
Vol. 50
Issue 12
Pg. 2433-2447
(Dec 2021)
ISSN: 1432-2161 [Electronic] Germany |
PMID | 34013448
(Publication Type: Journal Article)
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Copyright | © 2021. ISS. |
Chemical References |
- Sclerosing Solutions
- Sodium Tetradecyl Sulfate
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Topics |
- Adolescent
- Adult
- Bone Cysts, Aneurysmal
(drug therapy)
- Child
- Female
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Sclerosing Solutions
(therapeutic use)
- Sclerotherapy
- Sodium Tetradecyl Sulfate
(therapeutic use)
- Spine
(pathology)
- Treatment Outcome
- Young Adult
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