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Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension.

Methods

From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior–lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case.

Results

Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24–72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain.

Conclusions

Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Neuroradiology Service, AORNA Cardarelli, Naples, Italy

    G. Guarnieri, G. Ambrosanio, P. Vassallo, R. Galasso, A. Lavanga, R. Izzo & M. Muto

  2. Radiology Service, Seconda Università degli studi di Napoli—SUN, Naples, Italy

    M. G. Pezzullo

  3. via Catullo 30, 80122, Naples, Italy

    G. Guarnieri

Authors
  1. G. Guarnieri
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  2. G. Ambrosanio
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  3. P. Vassallo
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  4. M. G. Pezzullo
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  5. R. Galasso
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  6. A. Lavanga
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  7. R. Izzo
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  8. M. Muto
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Correspondence to G. Guarnieri.

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Guarnieri, G., Ambrosanio, G., Vassallo, P. et al. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up. Neuroradiology 51, 471–476 (2009). https://doi.org/10.1007/s00234-009-0520-0

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  • DOI: https://doi.org/10.1007/s00234-009-0520-0

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