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| SHEN Bin,MENG Yang,ZHAO Weidong.Imaging appearance and surgical management for symptomatic vertebral hemangioma[J].Chinese Journal of Spine and Spinal Cord,2013,(3):251-256. |
| Imaging appearance and surgical management for symptomatic vertebral hemangioma |
| Received:May 20, 2012 Revised:February 06, 2013 |
| English Keywords:Vertebral hemangioma Vertebroplasty Surgical treatment |
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| English Abstract: |
| 【Abstract】 Objectives: To investigate the imaging appearance, surgical management and the outcome for symptomatic vertebral hemangioma. Methods: 17 cases(5 males and 12 females) suffering from symptomatic vertebral hemangioma with an average age of 47.1 years(range, 27-68 years) were observed from May 2006 to May 2012. There were 18 vertebrae involved in this group. 7 cases had defect sited in thoracic and 11 in lumbar. Pain was the major complain of these cases(77.8%, 13/17), 4 cases had neurological deficit(22.2%) which included 2 Frankel C and 2 Frankel D. The disease course in this group was 8 months to 36 months. Cases suffering from pain and having defect locating in vertebral body(13 cases) underwent percutaneous vertebroplasty(PVP), while those with radiculopathy and having defect penetrating the vertebral wall(2 cases) underwent laminectomy plus intraoperative vertebroplasty, vertebrectomy and reconstruction combined with intraoperative vertebroplasty was performed on aggressive cases with circumferential compression and posterior elements involved(2 cases). The VAS scale and SF-36 scale were applied in patients for evaluating pain and quality of life at follow-up. Results: The mean operation time and blood loss was 95min and 265ml respectively. All patients started to walk within 2 weeks after surgery. Pathological finding confirmed 15 cavernous hemangiomas and 2 capillary hemangiomas. The mean follow-up was 28.2 months(range, 4-60 months). All cases got satisfied pain relief and could live free of analgesics. There was significant difference in postoperative VAS and SF-36(1.4±0.8 and 89.3±7.2) compared with preoperative ones(7.6±1.3 and 45.2±5.4). 4 patients with neurological deficit got good recovery from Frankel C or D to Frankel E, with a mean recovery time of 5.4 months. No recurrence, instrument failure, and pseudarthrosis were observed in this group. Conclusions: The surgical management and its outcome of symptomatic vertebral hemangioma depend on the imaging finding and clinical symptom, which can be managed by vertebroplasty alone or combination with other intervention. |
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