Thoracic aggressive vertebral hemangioma with neurologic deficit

Abstract

The aim of this study is to evaluate the safety and effectiveness in the treatment of thoracic aggressive vertebral hemangiomas (AVHs) with neurologic deficit by multiple surgical treatments.The clinical and radiographic data of 5 patients suffering from thoracic AVHs with neurologic deficit and treated by multiple surgical treatments, including percutaneous curved vertebroplasty (PCVP) combined with pedicle screw fixation and decompressive laminectomy, were reviewed and analyzed retrospectively.Five patients (3 women and 2 man, with a mean age of 57.40 ± 11.93) were diagnosed with AVHs from July 2010 to April 2016. All of them had objective neurologic deficit, myelopathy, and back pain. They underwent multiple surgical treatments and were followed-up for 12 to 23 months. At final follow-up, Frankel Grade D was achieved in all 5 patients. Patients were free from pain and neurologic symptoms, and the functional status was improved. No major complication was found.The treatment of AVHs with neurologic deficit is a challenge for surgeons. PCVP combined with pedicle screw fixation and decompressive laminectomy is safe and effective, and can be used for AVHs with neurologic deficit. Further studies with more samples are required to validate the effectiveness and safety of PCVP combined with pedicle screw fixation and decompressive laminectomy.

Hemangioma intraósseo difuso agressivo: Relato de caso

“…However, in rare cases, they may be aggressive, with neurological deficit due to spinal cord compression. 1,2,[5][6][7][8] The evolutionary form of the present case demonstrates aggressive and nonconcomitant diffuse lesions in a symp-tomatic male patient, with the appearance of new hemangiomas during follow-up, which were not subject to conservative treatment.…”

“…Contudo, em raros casos, heman-giomas podem se apresentar agressivos, com déficit neurológico decorrente de compressão medular. 1,2,[5][6][7][8] A forma evolutiva do presente caso demonstra lesões difusas, em paciente masculino, sintomáticas, agressivas e não concomitantes, com surgimento de novos hemangiomas durante o seguimento, não passíveis de tratamento conservador.…”

Clinical Evaluation of Preoperative Embolization, Vertebroplasty, and Decompression in the Treatment of Aggressive Vertebral Hemangiomas

“…The treatment of this disease mainly includes surgical resection, vertebroplasty, endovascular embolization, and radiotherapy [8][9][10] . Due to the abundant blood supply of an aggressive vertebral hemangioma and more bleeding during surgery, traditional total vertebral resection is no longer regarded as the mainstream approach [11] . Therefore, an increasing number of scholars recommend perioperative measures to control bleeding, such as radiotherapy, embolization, and vertebroplasty [8,[12][13][14] .…”

A case series for Enneking Stage III vertebral hemangiomas management, outcome, and literature review

“…These are usually confined to the vertebral body rather than the posterior bony elements of the spine. [1][2][3][4] The most common location of these tumors is the thoracic spine followed by the lumbar spine. [2,5] However, unlike vascular malformations, VH does not have arteriovenous shunting.…”

“…[1][2][3][4] The most common location of these tumors is the thoracic spine followed by the lumbar spine. [2,5] However, unlike vascular malformations, VH does not have arteriovenous shunting. [2] VH represents 2-3% of spinal tumors, and they are incidentally found in up to 12% of the general autopsies.…”