Radiotherapy for acute, high-grade spinal cord compression caused by vertebral hemangioma

Sewell, Mathew D.; Dbeis, Rachel; Bliss, P.; Watkinson, Tony; Hutton, Mike

doi:10.1016/j.spinee.2015.10.018

Cited by 13 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[26] Mathew et al treated a patient with acute, high-grade spinal cord compression caused by a vertebral hemangioma with radiotherapy and steroid treatment alone, and noted that clinical and radiological improvement may require several months to occur. [27] A study from a single center retrospectively analyzed 137 cases and, demonstrated the efficacy of radiotherapy in improving pain secondary to vertebral hemangiomas. The recommended dose was 36 to 40 Gy delivered in 2-Gy fractions.…”

Section: Discussionmentioning

confidence: 99%

Multifocal intraosseous hemangioma

Yao

Tang

et al. 2019

Medicine

View full text Add to dashboard Cite

Rationale:Multifocal intraosseous hemangioma, which affects multiple body parts, is rare. The selection of appropriate lesion sites for biopsy and effective treatment in multifocal intraosseous hemangioma is challenging. Here, we report a case of multifocal intraosseous hemangioma.Patient concerns:A 49-year-old woman was admitted to our department with a chief complaint of aggravated lumber pain for 10 days.Diagnoses:Radiographic imaging revealed lesions involving the bilateral ribs, lumbar vertebrae, ilium, pubis, and proximal femur. Open biopsy in the ilium established the pathological diagnosis of intraosseous hemangioma.Interventions:For the symptomatic lumbar spine, the patient selected radiotherapy as the initial treatment.Outcomes:As of the one-year follow-up, no symptoms of recurrence have been observed.Lessons:This rare case demonstrates the importance of the selection of the appropriate lesion to confirm the diagnosis and effective treatment for patients with multifocal disease. Radiotherapy plays an important role in the treatment of patients with symptomatic vertebral hemangiomas without neurologic deficits.

show abstract

Section: Discussionmentioning

confidence: 99%

Multifocal intraosseous hemangioma

Yao

Tang

et al. 2019

Medicine

View full text Add to dashboard Cite

show abstract

“…Also, the recovery of neurological function is usually slow following treatment of vertebral hemangioma [ 10 , 19 ]. In a study by Aich et al [ 20 ], radiotherapy was effective in six patients with vertebral hemangioma with neurological deficit.…”

Section: Discussionmentioning

confidence: 99%

The Role of Radiotherapy and Surgery in the Management of Aggressive Vertebral Hemangioma: A Retrospective Study of 20 Patients

et al. 2018

View full text Add to dashboard Cite

BackgroundVertebral hemangioma is usually a benign and asymptomatic tumor of blood vessels, but can be aggressive (symptomatic) with expansion, pain, and spinal cord compression. The aim of this study was to review the effects of radiotherapy, surgery, and other treatment approaches in patients with aggressive vertebral hemangioma.Material/MethodsRetrospective clinical review included 20 patients who underwent radiotherapy as their first-line treatment for aggressive vertebral hemangioma with mild or slowly developing neurological deficit. External radiation was divided into 20–25 fractions with a total dose of 40–50 Gy. Minimum clinical follow-up after treatment was 20 months.ResultsThe 20 patients included eight men and 12 women (mean age, 46.6 years), with aggressive vertebral hemangioma located in the cervical, thoracic, and lumbar vertebrae in four, 14, and two patients, respectively. Following radiotherapy treatment, 65.0% of patients (13/20) were symptom-free, without recurrence or malignant transformation at the time of last clinical follow-up (average, 75.2 months). Due to minor post-radiation vertebral re-ossification, two of the 13 patients who were initially symptom-free after radiotherapy requested percutaneous vertebroplasty. A further seven patients required surgery after radiotherapy, due to increasing neurological deficit in three patients, and persistent neurological deficit in four patients. At the last follow-up (average, 63.6 months), six patients were symptom-free, and one patient still had slight residual symptoms.ConclusionsRadiotherapy was a safe and effective treatment choice for aggressive vertebral hemangioma, but in case with severe spinal cord compression and neurological deficit, surgical intervention was required.

show abstract

“…[ 3 , 10 ] Only 0.9–1.2% of hemangiomas cause symptoms consisting of local back pain (e.g., involving a vertebral body), radiculopathy from nerve root compression/myelopathy (e.g., due to epidural expansion/spinal cord compression). [ 3 , 5 , 10 , 16 ] A common choice of treatment for painful aggressive VH (AVH) without neurological compromise is vertebroplasty or kyphoplasty, while those with spinal cord compression may require decompression with/without tumor removal. [ 11 , 13 , 15 , 16 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 3 , 5 , 10 , 16 ] A common choice of treatment for painful aggressive VH (AVH) without neurological compromise is vertebroplasty or kyphoplasty, while those with spinal cord compression may require decompression with/without tumor removal. [ 11 , 13 , 15 , 16 ]…”

Section: Introductionmentioning

confidence: 99%

Tubular laminectomy and percutaneous vertebroplasty for aggressive vertebral hemangioma

Papadakos¹,

Boulieris²,

Theofanopoulos³

et al. 2021

Surgical Neurology International

View full text Add to dashboard Cite

Background: Vertebral hemangiomas (VH) are the most common benign vascular neoplasms of the spine. Aggressive VH (AVH) may become symptomatic due to soft-tissue expansion/extraosseous extension into the paraspinal and/or epidural spaces. There are several options for treating painful AVH, including radiotherapy and/or open surgery. Case Description: A 59-year-old male presented with a 2-year history of intermittent back pain and progressive thoracic myelopathy in the past 2 months. MRI revealed a T9 level lesion, with high-intensity signal on both T1 and T2 images and an extraosseous component with significant cord compression. We performed minimally invasive tubular unilateral laminotomy for bilateral decompression of the thoracic spine at the T9 level, followed by bilateral percutaneous vertebroplasty with biopsy. Postoperatively, the pain was immediately relieved, and the myelopathy improved. The biopsy confirmed the diagnosis of a VH. Conclusion: Combining minimally invasive techniques consisting of tubular laminectomy and percutaneous vertebroplasty are safe and effective ways for treating AVHs.

show abstract

Radiotherapy for acute, high-grade spinal cord compression caused by vertebral hemangioma

Cited by 13 publications

References 0 publications

Multifocal intraosseous hemangioma

Multifocal intraosseous hemangioma

The Role of Radiotherapy and Surgery in the Management of Aggressive Vertebral Hemangioma: A Retrospective Study of 20 Patients

Tubular laminectomy and percutaneous vertebroplasty for aggressive vertebral hemangioma

Contact Info

Product

Resources

About