Long-term outcome of percutaneous alcohol embolization combined with percutaneous vertebroplasty in aggressive vertebral hemangiomas with epidural extension
- 370 Downloads
To evaluate, on a long-term basis, the safety and effectiveness of percutaneous alcohol embolization (PAE) combined with percutaneous vertebroplasty (PVP) as a sole treatment for aggressive vertebral haemangiomas (AVHs) with epidural extension.
From 1996 to 2015, 26 consecutive patients (15 women [58%] and 11 men; mean age 51.8 years [range: 19–75 years]) underwent PAE combined with PVP (performed at day 15) for the treatment of 27 AVHs with epidural extension. Clinical outcome was evaluated with a mean delay of 88.3 ± 53.3 months (range: 22–217 months). The primary endpoint was pain relief evaluated with a visual analogue scale (VAS).
Pre-procedure mean VAS score was 7.23 ± 1.3 and significantly improved at last follow-up (m = 3.11 ± 1.9; p < 0.001). Ten patients (38.5%) remained asymptomatic. Eighty-eight percent of the patients with neurosensory disorders had complete regression of these symptoms. Two of the three patients with motor deficit did not show any improvement. No major complication was recorded.
PAE combined with PVP is a minimally invasive safe and effective therapeutic approach for AVH with epidural involvement, even on long-term clinical outcome. This technique appears mainly effective for pain and neurosensory symptoms, but seems less effective for motor deficit relief.
• Combination of PAE with PVP is a safe technique.
• PAE combined with PVP is an effective treatment for sensory symptoms.
• This strategy seems less effective in patients with motor deficits.
KeywordsIntraosseous haemangioma Cementoplasty Alcohol embolization Percutaneous Vertebral
Abbreviations and acronyms
Aggressive vertebral haemangioma
Digital subtraction angiography
Medical Research Council
Magnetic resonance imaging
Percutaneous alcohol embolization
Visual analogue scale
The scientific guarantor of this publication is Jacques Chiras. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Neither approval from the institutional review board nor patient informed consent are required by the ethics committee of our institution for retrospective analyses of patients’ records and imaging data. Methodology: retrospective, observational, performed at one institution.
- 1.Schmorl J (1960) The human spine in health and disease. New York and London: Grune and Stratton. Br J Surg 47:694Google Scholar
- 17.Chen L, Zhang C, Tang T (2007) Cement vertebroplasty combined with ethanol injection in the treatment of vertebral hemangioma. Chin Med J (Engl) 120:1136–1139Google Scholar
- 23.Boschi V, Pogorelić Z, Gulan G et al (2011) Management of cement vertebroplasty in the treatment of vertebral hemangioma. Scand J Surg SJS Off Organ Finn Surg Soc Scand Surg Soc 100:120–124Google Scholar