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Surgical treatment of compressive spinal hemangioma

A case series of three patients and literature review

Chirurgische Behandlung des komprimierenden spinalen Hämangioms

Fallserie mit 3 Patienten und Literaturübersicht

Der Orthopäde volume 47, pages 221–227 (2018)Cite this article

Abstract

Purpose

In this article we describe the treatment of compressive vertebral hemangioma.

Methods

Our case series comprised three patients with aggressive hemangioma. We performed a combination of posterior decompression and vertebroplasty for the two patients with a sacral hemangioma and a thoracic hemangioma, and en bloc resection for the third patient, who also had a thoracic lesion.

Results

Surgical intervention is indicated in cases of rapidly progressive tumors or severe myelopathy. All three patients had good clinical results. The follow-up period ranged from 8 to 56 months. The mean blood loss was around 700 ml, and mean surgical time was 2.1 h. Blood loss for the en bloc procedure was around 1,200 ml, and surgical time was 2.3 h.

Conclusion

A combination of posterior decompression, vertebroplasty, and posterior fixation for aggressive hemangioma can reduce blood loss during surgery. For patients with hemangioma and with incomplete paralysis, total en bloc spondylectomy should be considered. Adjuvant radiotherapy can reduce the recurrence of cavernous vertebral hemangiomas.

Zusammenfassung

Ziel der Arbeit

In dem vorliegenden Beitrag beschreiben die Autoren die Behandlung des komprimierenden Wirbelhämangioms.

Methoden

Die vorliegende Fallserie umfasst 3 Patienten mit aggressiven Hämangiomen. Bei den beiden Patienten mit einem Sakral- und einem Thorakalhämangiom führten die Autoren eine Kombination aus einer posterioren Dekompression und Vertebroplastie durch. Bei dem dritten Patienten, der ebenfalls eine thorakale Läsion aufwies, wurde eine eine En-bloc-Resektion durchgeführt.

Ergebnisse

Eine chirurgische Intervention ist indiziert in Fällen mit einem schnell fortschreitenden Tumor oder einer schweren Myelopathie. Alle 3 Patienten wiesen gute klinische Ergebnisse auf. Die Nachsorgephase reichte von 8 bis zu 56 Monaten. Im Mittel betrug der Blutverlust etwa 700 ml und die Op.-Dauer 2,1 h. Bei dem En-bloc-Verfahren lag der Blutverlust bei etwa 1200 ml und die Op.-Dauer bei 2,3 h.

Schlussfolgerung

Eine Kombination aus posteriorer Dekompression, Vertebroplastie und posteriorer Fixation bei aggressivem Hämangiom kann den Blutverlust während der Op. vermindern. Bei Patienten mit Hämangiom und inkompletter Lähmung sollte eine totale En-bloc-Spondylektomie erwogen werden. Mit adjuvanter Strahlentherapie kann die Rezidivrate kavernöser Wirbelhämangiome gesenkt werden.

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Authors and Affiliations

  1. Department of Spine Surgery, Ningbo No. 6 Hospital, No. 1059, Zhongshan East Road, Ningbo, China

    Yun-lin Chen, Xu-dong Hu, Nan-jian Xu, Wei-yu Jiang & Wei-hu Ma

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  1. Yun-lin Chen
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  2. Xu-dong Hu
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  3. Nan-jian Xu
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Corresponding author

Correspondence to Wei-hu Ma.

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Conflict of interest

Y.-l. Chen, X.-D. Hu, N.-J. Xu, W.-Y. Jiang, and W.-H. Ma declare that they have no competing interests.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975 (in its most recently amended version). Informed consent was obtained from all patients included in the study.

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Chen, Yl., Hu, Xd., Xu, Nj. et al. Surgical treatment of compressive spinal hemangioma. Orthopäde 47, 221–227 (2018). https://doi.org/10.1007/s00132-017-3503-6

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Keywords

  • Spinal cord compression
  • Spinal neoplasms
  • Cavernous hemangioma
  • Vertebroplasty
  • Surgery

Schlüsselwörter

  • Rückenmarkkompression
  • Spinale Neoplasien
  • Kavernöses Hämangiom
  • Vertebroplastie
  • Chirurgie