Aspiration and injection for treatment of bone cyst
CPT4 code
Name of the Procedure:
Aspiration and Injection for Treatment of Bone Cyst (also known as therapeutic aspiration and sclerotherapy of bone cysts)
Summary
Aspiration and injection for the treatment of a bone cyst involve drawing fluid out of the cyst (aspiration) and then injecting a therapeutic substance to help the bone heal, such as a bone-hardening agent or corticosteroid. This minimally invasive procedure is often performed by a radiologist using imaging guidance.
Purpose
Aspiration and injection of a bone cyst address abnormalities in the bone where fluid-filled sacs (cysts) have developed. The goals are to reduce the cyst size, alleviate associated pain, promote bone healing, and prevent potential fractures.
Indications
- Symptomatic bone cysts causing pain or discomfort.
- Cysts that are growing or at risk of weakening the bone, leading to fractures.
- Failure of other non-invasive treatments to relieve symptoms or reduce cyst size.
- Radiographically confirmed bone cysts through X-rays or MRI scans.
Preparation
- The patient may be instructed to fast for a few hours before the procedure, depending on the type of anesthesia used.
- Adjustments to certain medications, particularly blood thinners, may be necessary.
- Pre-procedure imaging, such as X-rays or MRI, to locate and assess the cyst.
Procedure Description
- The procedure typically begins with local anesthesia to numb the area around the cyst.
- Using imaging guidance (e.g., ultrasound or fluoroscopy), a needle is carefully inserted into the cyst.
- Fluid from the cyst is aspirated (drawn out) for analysis.
- After aspiration, a therapeutic agent like a corticosteroid or bone-hardening substance is injected into the cyst to aid in healing and prevent recurrence.
- The needle is then removed, and a small bandage is applied.
Duration
The entire procedure generally takes about 30 to 60 minutes.
Setting
The procedure is usually performed in an outpatient clinic, radiology department, or surgical center with imaging facilities.
Personnel
- Radiologist or orthopedic surgeon specialized in bone procedures.
- Radiologic technologist or nurse to assist and monitor the patient.
- Anesthesiologist or nurse anesthetist, if sedation is required.
Risks and Complications
- Infection at the injection site.
- Minor bleeding or bruising.
- Injury to surrounding nerves or blood vessels.
- Recurrence of the cyst requiring additional treatment.
- Allergic reactions to anesthetic or injected substances.
Benefits
- Reduction in cyst size and associated symptoms.
- Promotion of bone healing and stability.
- Minimally invasive with a shorter recovery time compared to surgical options.
- Immediate symptomatic relief in many cases.
Recovery
- Post-procedure the patient may experience mild discomfort or soreness at the injection site, typically managed with over-the-counter pain relief.
- Patients can usually resume normal activities within a day but may need to avoid strenuous activities for a few days.
- Follow-up imaging to monitor the cyst and bone healing process is often required.
Alternatives
- Observation and monitoring, especially for asymptomatic cysts.
- Surgical removal or curettage of the cyst.
- Bone grafting procedures.
- Pros: Less invasive options like observation might avoid procedural risks. Surgery could offer a permanent solution.
- Cons: Observation may allow the cyst to grow or cause symptoms. Surgery may have a longer recovery period and more significant risks.
Patient Experience
During the procedure, the patient may feel minimal discomfort due to local anesthesia. Post-procedure soreness at the site can be expected but is generally mild and manageable with pain medication. Patients benefit from a relatively quick recovery and can experience symptom relief soon after the procedure. Regular follow-up appointments ensure monitoring and management of the condition.