Aneurysmal bone cyst of the atlas: successful treatment through selective arterial embolization: case report.

Journal Article (Journal Article)

Objective and importance

Aneurysmal bone cysts (ABCs) are benign and expansile osteolytic lesions that can occur in any location in the spine, including the craniovertebral junction. Aggressive resection followed by bone grafting has been the mainstay of treatment, with selective arterial embolization as a presurgical adjunct. Complete excision of these lesions at the craniovertebral junction is associated with high surgical morbidity. We report a case of successful treatment of an ABC of the atlas in a child with selective arterial embolization alone.

Clinical presentation

A 10-year-old girl presented with persistent neck pain after a snowboarding accident. Computed tomography and magnetic resonance imaging of the cervical spine revealed an expansile cystic mass involving the right lateral mass of C1. Digital subtraction angiography revealed a tumor blush, which, along with the cystic appearance of the lesion, was consistent with an ABC.


The arterial feeders to the lesion were selectively embolized with polyvinyl alcohol particles. Three sessions of embolization were required to eradicate the blood supply to the lesion completely.


Complete surgical resection of ABCs at the craniovertebral junction can be associated with high morbidity secondary to the highly vascular and destructive nature of these lesions. The case discussed here demonstrates the viability of selective arterial embolization as a primary and stand-alone modality of treatment.

Full Text

Duke Authors

Cited Authors

  • Mohit, AA; Eskridge, J; Ellenbogen, R; Shaffrey, CI

Published Date

  • October 2004

Published In

Volume / Issue

  • 55 / 4

Start / End Page

  • 982 -

PubMed ID

  • 15934182

Electronic International Standard Serial Number (EISSN)

  • 1524-4040

International Standard Serial Number (ISSN)

  • 0148-396X

Digital Object Identifier (DOI)

  • 10.1227/01.neu.0000137279.58768.7e


  • eng