Department of Neurosurgery, College of Medicine, University of Iowa Carver, 200 Hawkins Drive, Iowa City, Iowa 52242 USA.
College of Medicine, University of Iowa Carver, 200 Hawkins Drive, Iowa City, Iowa 52242 USA.
Spine J. 2023 Sep;23(9):1243-1254. doi: 10.1016/j.spinee.2023.04.002. Epub 2023 Apr 12.
Vertebral hemangiomas (VHs), formed from a vascular proliferation in bone marrow spaces limited by bone trabeculae, are the most common benign tumors of the spine. While most VHs remain clinically quiescent and often only require surveillance, rarely they may cause symptoms. They may exhibit active behaviors, including rapid proliferation, extending beyond the vertebral body, and invading the paravertebral and/or epidural space with possible compression of the spinal cord and/or nerve roots ("aggressive" VHs). An extensive list of treatment modalities is currently available, but the role of techniques such as embolization, radiotherapy, and vertebroplasty as adjuvants to surgery has not yet been elucidated. There exists a need to succinctly summarize the treatments and associated outcomes to guide VH treatment plans. In this review article, a single institution's experience in the management of symptomatic VHs is summarized along with a review of the available literature on their clinical presentation and management options, followed by a proposal of a management algorithm.
脊柱血管瘤（VH）是一种由骨小梁限制的骨髓腔血管增殖形成的良性肿瘤，是脊柱最常见的良性肿瘤。大多数 VH 处于临床静止状态，通常只需要监测，但很少会引起症状。它们可能表现出活跃的行为，包括快速增殖、超出椎体范围，并侵犯椎旁和/或硬膜外间隙，可能压迫脊髓和/或神经根（“侵袭性”VH）。目前有广泛的治疗方法，但栓塞、放疗和椎体成形术等技术作为手术辅助的作用尚未阐明。需要简明地总结治疗方法和相关结果，以指导 VH 的治疗计划。在这篇综述文章中，总结了单一机构在治疗有症状的 VH 方面的经验，并回顾了有关其临床表现和治疗选择的现有文献，随后提出了一种管理算法。
