Department of Surgery, University Hospital Split and Split University School of Medicine, Split, Croatia.
Scand J Surg. 2011;100(2):120-4. doi: 10.1177/145749691110000210.
The vertebral hemangiomas are benign vascular lesions occurring in spine. Although uncommon, symptomatic vertebral hemangiomas can be painful and can limit daily activities. A number of methods have been used in the treatment of symptomatic and aggressive vertebral hemangioma, but none of them is optimal. Treatment with cement vertebroplasty showed very good results. This study aims to illustrate the validity of the treatment with cement vertebroplasty in patients with painful vertebral hemangiomas.
From January 2000 to January 2007, 24 patients were treated by percutaneous vertebroplasty because of hemangioma: 16 thoracic, 8 lumbar. There were 11 males and 13 females. The average age at the time of surgery was 48 years. All the patients complained of a pain syndrome resistant to continuing medication. All patients underwent X-ray examination, CT-scan and MR of the involved level preoperatively. A unipedicular approach under fluoroscopic guidance has been performed in all patients. All procedures have been carried out under the local anesthesia. The mean follow-up was 5.8 years.
In all the patients a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular cement leakage has been observed in 3 patients, without any clinical radicular syndrome onset due to the epidural diffusion. Clinical and radiological follow-up showed stability of the treatment and absence of pain in all patients.
Percutaneous treatment with vertebroplasty for symptomatic vertebral hemangiomas is a valuable, less-invasive, and a quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of the vertebral body's fracture.
椎体血管瘤是发生在脊柱的良性血管性病变。虽然不常见，但有症状的椎体血管瘤可能会引起疼痛，并限制日常活动。目前已经有许多方法被用于治疗有症状和侵袭性的椎体血管瘤，但没有一种方法是完美的。骨水泥椎体成形术治疗效果非常好。本研究旨在阐明骨水泥椎体成形术治疗疼痛性椎体血管瘤的有效性。
2000 年 1 月至 2007 年 1 月，24 例患者因血管瘤行经皮椎体成形术治疗：胸椎 16 例，腰椎 8 例。男性 11 例，女性 13 例。手术时的平均年龄为 48 岁。所有患者均有止痛药物治疗无效的疼痛综合征。所有患者术前均行受累水平的 X 线检查、CT 扫描和 MRI。所有患者均在透视引导下进行单椎弓根入路。所有手术均在局部麻醉下进行。平均随访时间为 5.8 年。
所有患者的疼痛症状均完全缓解，疗效满意。3 例患者出现椎体外血管水泥渗漏，但由于硬膜外扩散，无任何神经根综合征发生。临床和放射学随访显示，所有患者的治疗均稳定，无疼痛。
经皮椎体成形术治疗有症状的椎体血管瘤是一种有价值的、微创的、快速的方法，可以完全持久地缓解疼痛性椎体症状，而不会导致椎体骨折。
