Lurie Children’s Develops Minimally Invasive Treatment for Unicameral Bone Cysts

January 04, 2022

From left: Drs. Shankar Rajeswaran, Terrance Peabody and Samer Attar

Lurie Children’s interventional radiology and orthopedic surgery specialists have developed a minimally invasive procedure that has promising early results in the treatment of unicameral bone cysts.

There is no standardized treatment of unicameral bone cysts and there are multiple different techniques with variable recurrence rates. Existing treatment options includes steroid injection, mechanical curettage, bone grafting, screw cannulation or a combination of these techniques.

Utilizing a novel technique developed and studied by Lurie Children’s Division Head of Interventional Radiology Dr. Shankar Rajeswaran and pediatric orthopedic specialists Drs. Terrance Peabody and Samer Attar, a new image-guided minimally invasive approach involving chemical sclerotherapy and bone grafting is now being used to treat UBCs.

In this image, the difference between the larger scar (in the bracket) and the incisions from the Lurie Children's-developed minimally invasive approach (arrows) is clear.

Chemical sclerotherapy disrupts the cyst wall, akin to curettage, and the cyst is then grafted with resorbable bone graft which expedites healing and return to activity time. The procedure is performed in an outpatient setting and takes less than 45 minutes and is performed entirely with needles with incisions closed with a band-aid.

Nearly 30 patients have undergone this procedure at Lurie Children’s in the last 3 years and though the results are early, this technique has shown recurrence rates at least on par with traditional mechanical curettage and grafting.

Given that this technique is minimally invasive, there is overall less morbidity associated with the procedure. In addition, if there is a recurrence, it can be easily treated with needles in a minimally invasive fashion.  

“The early results of the study have been very promising,” Dr. Rajeswaran said. “I feel confident that in a few years, there will be a growing movement towards treating UBCs in a minimally invasive fashion.”

Earlier this year, the team leading the effort published their preliminary clinical investigation in the journal CardioVascular and Interventional Radiology. View the abstract here. The study is ongoing.