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. 2018 Dec 21;12(6):695-702.
doi: 10.14444/5087. eCollection 2018 Dec.

Role of Bisphosphonates as Adjuvants of Surgery in Giant Cell Tumor of Spine

Chaitanya Dev Pannu  1 , Pankaj Kandhwal  1 , Vijay Raghavan  1 , Shah Alam Khan  1 , Shishir Rastogi  1 , Arvind Jayaswal  1
Affiliations

Role of Bisphosphonates as Adjuvants of Surgery in Giant Cell Tumor of Spine

Chaitanya Dev Pannu et al. Int J Spine Surg. .

Abstract

Background: The role of bisphosphonates is well established in giant cell tumor of bone (GCTB) of extremities, but its role in spine GCTB is still not established. Our main purpose was to evaluate the role of bisphosphonates in spinal GCTB with the help of radiologic assessment.

Methods: A retrospective analysis of all spine GCTB patients who underwent an operation from July 2005 to January 2014 was done. Patients of spine GCTB in whom bisphosphonates were given constituted the study group. This group was compared to patients in whom bisphosphonates were not given. Preoperative and postoperative radiographs and CT scans were studied. A thorough evaluation of the presence of sclerosis was done on them. Bisphosphonates were considered to be effective if either sclerosis or new bone formation was present.

Results: A total of 13 cases of spine GCT underwent operation from July 2005 to January 2014. All patients of GCTB spine who underwent an operation after 2008 at our institute were given bisphosphonates postoperatively. Of 13 cases, bisphosphonates were given postoperatively in 6 patients: 5 patients were female and 1 patient was male. Of these 6 patients, 3 patients had sacrum GCTB and 1 patient each had T9, T11, and L5 vertebrae GCTB. Average follow-up period was 39.33 months (minimum follow-up was 18 months and maximum follow-up was 72 months). Postoperative sclerosis was present in all 6 patients. No recurrence of the tumor was present in the bisphosphonate group, but 2 patients had a recurrence in the group that did not receive bisphosphonates.

Conclusions: Bisphosphonates are effective and safe adjuvant therapy along with appropriate surgical intervention in spinal GCTBs and may have a role in decreasing the recurrence of this tumor.

Keywords: bisphosphonates; cryotherapy; metastasis; osteoclast; radiotherapy.

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Conflict of interest statement

Disclosures and COI: The authors received no funding for this study and report no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative (pre-op) radiographs, computed tomography, (CT), and magnetic resonance imaging (MRI), of giant cell tumor of bone of D11 vertebrae.
Figure 2
Figure 2
Postoperative (pre-op) radiographs and computed tomography (CT) scan at an interval of 2 years showing sclerosis.
Figure 3
Figure 3
Postoperative radiographs and computed tomography (CT) scans of giant cell tumor of bone L5 vertebrae.
See this image and copyright information in PMC

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