Chen Yun-Lin, Hu Xu-Dong, Xu Nan-Jian, Jiang Wei-Yu, Ma Wei-Hu
Department of Spine Surgery, Ningbo No. 6 Hospital, No. 1059, Zhongshan East Road, Ningbo, China.
Orthopade. 2018 Mar;47(3):221-227. doi: 10.1007/s00132-017-3503-6.
In this article we describe the treatment of compressive vertebral hemangioma.
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.
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.
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.
在本文中，我们描述了压迫性椎体血管瘤的治疗方法。
我们的病例系列包括3例侵袭性血管瘤患者。对于2例分别患有骶骨血管瘤和胸椎血管瘤的患者，我们采用了后路减压和椎体成形术相结合的方法；对于第3例同样患有胸椎病变的患者，我们进行了整块切除。
对于快速进展性肿瘤或严重脊髓病患者，需进行手术干预。所有3例患者均取得了良好的临床效果。随访时间为8至56个月。平均失血量约为700毫升，平均手术时间为2.1小时。整块切除手术的失血量约为1200毫升，手术时间为2.3小时。
对于侵袭性血管瘤，后路减压、椎体成形术和后路固定相结合可减少手术中的失血量。对于患有血管瘤且不完全瘫痪的患者，应考虑进行全椎体整块切除术。辅助放疗可降低海绵状椎体血管瘤的复发率。
