Gajaseni Pawin, Labianca Luca, Lacerda Iara, Weinstein Stuart
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Department of Orthopedics, Phramongkutklao Hospital, Bangkok, Thailand.
JBJS Case Connect. 2017 Oct-Dec;7(4):e86. doi: 10.2106/JBJS.CC.17.00057.
We present a case of a pathologic vertebral fracture and encroachment into the spinal canal from a vertebral hemangioma in a 13-year-old boy. The original approach of embolization followed by an anterior-posterior resection and stabilization through a costotransversectomy had to be converted intraoperatively to a combined anterior and posterior approach secondary to excessive bleeding.
Because of the hypervascularity and the extensive nature of aggressive vertebral hemangiomas, surgeons attempting procedures similar to the case described herein must be prepared to adapt to the circumstances when preoperative embolization is not totally effective. Surgical technique, proper anesthesia, and patient clotting capacity are important factors to consider.
我们报告一例13岁男孩因椎体血管瘤导致病理性椎体骨折并侵犯椎管的病例。最初的治疗方法是先进行栓塞，然后通过肋横突切除术进行前后路切除和固定，但术中因出血过多，不得不改为前后联合入路。
由于侵袭性椎体血管瘤血管丰富且范围广泛，对于尝试进行类似于本文所述手术的外科医生来说，当术前栓塞不完全有效时，必须准备好随机应变。手术技术、适当的麻醉和患者的凝血能力是需要考虑的重要因素。
