Nguyen J P, Djindjian M, Badiane S
Service de Neurochirurgie, C.H.U. Henri Mondor 51, Créteil.
Neurochirurgie. 1989;35(5):270-4, 305-8.
45 cases of vertebral hemangiomas with neurologic involvement are reported. This series corresponds to the french experience between 1969 and 1988 (series of the "Société Française de Neurochirurgie" (S.F.N.)). In this report the clinical presentation and the results of the radiological examination are detailed. Local vertebral pain was present in half of the cases. The neurological symptoms were related to spinal cord compression in 33/45 of the patients and to radicular suffering in the other cases. Evolution of the neurological symptoms appeared to be slow: the mean evolution time before diagnosis was of 10 months. Hemangioma involved the thoracic column in 73% of the cases. Neurologic symptoms was due to a diffuse narrowing of the spinal canal in 28.8% of the cases, to a local bony expansion in 60% of the cases. Hemangioma was found to involve the whole vertebra in 44.4% of the cases, the vertebral body alone in 24.4% of the cases and the posterior arch alone in 22.2% of the cases. An incomplete involvement of both vertebral body and posterior arch was found in 6.6% of the cases. 2.2% of the cases corresponded to pure epidural hemangioma. Preoperative diagnosis was established in 58% of the patients. In these cases, the diagnosis was based on standard radiography and CT datas. Results of the S.F.N. serie are compared with those of the main series of the literature.
报告了45例伴有神经受累的椎体血管瘤。该系列病例与1969年至1988年法国的经验相符（法国神经外科学会（S.F.N.）的系列病例）。本报告详细阐述了临床表现及放射学检查结果。半数病例存在局部椎体疼痛。33/45的患者神经症状与脊髓受压有关，其余病例则与神经根受累有关。神经症状的进展似乎较为缓慢：诊断前的平均进展时间为10个月。73%的病例中血管瘤累及胸椎。28.8%的病例中神经症状是由于椎管弥漫性狭窄所致，60%的病例是由于局部骨质膨胀所致。44.4%的病例中发现血管瘤累及整个椎体，24.4%的病例仅累及椎体，22.2%的病例仅累及后弓。6.6%的病例中椎体和后弓均有不完全受累。2.2%的病例为单纯硬膜外血管瘤。58%的患者术前得以确诊。在这些病例中，诊断基于标准X线摄影和CT数据。将S.F.N.系列病例的结果与文献中的主要系列病例结果进行了比较。
