Spinal cord compression caused by vertebral hemangioma being symptomatic during pregnancy

Kıroğlu, Yılmaz; Benek, Berk; Yagci, Baki; Çırak, Bayram; Tahta, Kadir

doi:10.1016/j.surneu.2007.09.025

Cited by 49 publications

(46 citation statements)

References 22 publications

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“…8 They have a prevalence of 10% in the general population, but are symptomatic in only 1% of cases. 16 Based on a retrospective review of symptomatic patients, Fox and Onofrio reported that 54% of patients complained of back pain and 45% presented with neurological signs. 12 Several mechanisms of spinal cord compression have been identified.…”

Section: Discussionmentioning

confidence: 99%

“…13 Since that first publication, 27 new cases have been described (Table 1). 1,[3][4][5][6][7][8][9][10][11][13][14][15][16][18][19][20][21][22][23][24][25][26][27][28][29] The diagnosis was usually made during the third trimester (22 of 27 cases). The mean maternal age at the time of diagnosis was 30 years.…”

Section: Discussionmentioning

confidence: 99%

“…The trabecular patterns of the vertebra presented with a typical hatched, or beehive, appearance. 16 After establishing the diagnosis, therapeutic management remains difficult and controversial, as it must take into account the maternal neurological risk, the fetal risk in utero, and the risk of prematurity. The first decision concerns continuation or termination of the pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…8,[19][20][21]28 Only 1 of the 8 cases of prematurity (between 32 and 36 weeks of gestation) 1,3,10,[13][14][15]19,23 was treated antepartum. 13 Finally, only 1 of the 7 cases close to term (beyond 36 weeks of gestation) 4,5,16,22,25,27 at the time of diagnosis was treated antepartum. 22 Despite the absence of sufficient data or even a consensus, Chi et al 8 have proposed a treatment algorithm.…”

Section: Discussionmentioning

confidence: 99%

“…12,18 They are generally asymptomatic, as only 1% of hemangiomas are symptomatic in the general population. 16 They can be responsible for simple back pain or may present as a diagnostic and therapeutic emergency with spinal cord compression, usually related to bone expansion within the vertebral canal. 12,18 Pregnancy is a recognized factor in deterioration of hemangiomas.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Symptomatic vertebral hemangiomas during pregnancy

Moles¹,

Hamel

Perret

et al. 2014

SPI

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Symptomatic vertebral hemangiomas during pregnancy are rare, as only 27 cases have been reported in the literature since 1948. However, symptomatic vertebral hemangiomas can be responsible for spinal cord compression, in which case they constitute a medical emergency, which raises management difficulties in the context of pregnancy. Pregnancy is a known factor responsible for deterioration of these vascular tumors. In this paper, the authors report 2 clinical cases of symptomatic vertebral hemangiomas during pregnancy, including 1 case of spontaneous fracture that has never been previously reported in the literature. The authors then present a brief review of the literature to discuss emergency management of this condition. The first case was a 28-year-old woman at 35 weeks of gestation, who presented with paraparesis. Spinal cord MRI demonstrated a vertebral hemangioma invading the body and posterior arch of T-3 with posterior epidural extension. Laminectomy and vertebroplasty were performed after cesarean section, allowing neurological recovery. The second case involved a 35-year-old woman who presented with spontaneous fracture of T-7 at 36 weeks of gestation, revealing a vertebral hemangioma with no neurological deficit, but it was responsible for pain and local instability. Treatment consisted of postpartum posterior interbody fusion. With a clinical and radiological follow-up of 2 years, no complications and no modification of the hemangiomas were observed. A review of the literature reveals discordant management of these rare cases, which is why the treatment course must be decided by a multidisciplinary team as a function of fetal gestational age and maternal neurological features.

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Section: Discussionmentioning

confidence: 99%