• Akinori Okuda, Hideki Shigematsu, Eiichiro Iwata, Masato Tanaka, Yasuhiko Morimoto, Keisuke Masuda, Chiho Ohbayashi, and Yasuhito Tanaka.
• 1 Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan.
• J Orthop Surg (Hong Kong). 2019 May 1; 27 (2): 2309499019839626.

AbstractAneurysmal bone cysts (ABCs) rarely trigger pathological fractures. Various surgical and nonsurgical treatments have been reported for this condition. Herein, we present the examination findings and treatment for a 15-year-old girl who initially presented with adolescent idiopathic scoliosis and mild back pain, but subsequently experienced severe back pain. Magnetic resonance imaging revealed an ABC at T1, with an associated pathological fracture. We successfully treated the patient using posterior fixation with instrumentation, curettage, and bone grafts combined with calcitonin and methylprednisolone (mPSL). At 3 years post-surgery, there was no ABC recurrence and only mild back pain persisted. To our knowledge, this is the first report of open surgery (curettage and fixation) with local intralesional administration of calcitonin and mPSL for an ABC-induced pathological spinal fracture. We believe that this treatment is an effective option for ABCs associated with a pathological spinal fracture.

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