What question did this study set out to answer?

This review aims to evaluate current management strategies for aneurysmal and simple bone cysts and their outcomes.

March 21, 2026Open Access

The best solution is the simplest: advances in surgical and minimally invasive management of aneurysmal and simple bone cysts

AAAbdulrahman AlaseemKing Saud University AAAbdullah AddarKing Saud University MAMishari AlaneziKing Saud University

Key Points

This review aims to evaluate current management strategies for aneurysmal and simple bone cysts and their outcomes.
Review of current evidence on treatment strategies for ABCs and SBCs
Analysis of surgical approaches including intralesional curettage
Evaluation of minimally invasive techniques such as sclerotherapy and embolization
Discussion of recurrence rates and functional outcomes under different management methods
Intralesional curettage shows variable recurrence rates, which can be reduced with adjuvants.
Minimally invasive techniques achieve high healing and pain relief rates with fewer complications.
Elastic stable intramedullary nailing demonstrates high healing rates for simple bone cysts.
En bloc resection is effective but associated with higher morbidity and poor functional outcomes.

Abstract

Aneurysmal bone cysts (ABCs) and simple bone cysts (SBCs) are benign osseous lesions predominantly affecting children and adolescents, typically presenting with pain, deformity, or pathologic fracture. Despite their frequency, optimal management remains debated. This review synthesizes current evidence on therapeutic strategies, efficacy, recurrence, and safety. For ABCs, intralesional curettage remains the standard surgical approach, though recurrence rates vary and are reduced with adjuvants such as high-speed burring, cryotherapy, or cementation. En bloc resection offers the lowest recurrence; however, it is restricted by procedural morbidity and poor functional outcomes. Minimally invasive modalities, including sclerotherapy, selective arterial embolization, endoscopic curettage, and image-guided ablation, consistently achieve high rates of healing, pain relief, and functional recovery, often with fewer complications. Management of SBCs ranges from observation to intervention in symptomatic or unstable lesions. Elastic stable intramedullary nailing (ESIN) provides both decompression and structural stability, with high healing rates. Overall, advances in minimally invasive and biologic therapies are reshaping treatment paradigms, yet standardized outcome measures and head-to-head comparative trials remain needed.

Ask AI

Helpful

Bookmark

View Full Paper