Potparić Igor, Brumat Peter, Bošnjak Klemen, Vodičar Miha
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
Department of Orthopaedic Surgery, Ljubljana University Medical Centre, Zaloška cesta 9, 1000 Ljubljana, Slovenia.
J Surg Case Rep. 2024 Jul 16;2024(7):rjae461. doi: 10.1093/jscr/rjae461. eCollection 2024 Jul.
Vertebral haemangiomas are common amongst primary benign tumours of the spine, usually asymptomatic and discovered incidentally, whereby symptomatic cases are rare. Aggressive vertebral haemangiomas, occurring even less frequently, are characterized by their expansion, resulting in pain and neural compression symptoms. Depending on presentation and severity, several treatment options exist, and when causing progressive neurological deficit, surgical decompression and resection is warranted. Despite local recurrence being rare, regular follow-ups to detect recurrence are advised. In case of recurrent aggressive vertebral haemangiomas, however, subsequent treatment strategy usually depends on a case-by-case consideration, whereby reports in the literature are lacking. We describe a case of a recurrent aggressive vertebral haemangiomas of the thoracic spine in a 20-year-old male causing progressive thoracic myelopathy with segmental kyphosis, treated with a revision total en bloc spondylectomy and a multilevel fixation with vertebral column reconstruction using radiolucent instrumentation.
椎体血管瘤在脊柱原发性良性肿瘤中较为常见，通常无症状，多为偶然发现，有症状的病例很少见。侵袭性椎体血管瘤则更为罕见，其特点是肿瘤扩张，导致疼痛和神经受压症状。根据临床表现和严重程度，有多种治疗选择，当出现进行性神经功能缺损时，有必要进行手术减压和切除。尽管局部复发很少见，但建议定期随访以检测复发情况。然而，对于复发性侵袭性椎体血管瘤，后续的治疗策略通常需根据具体情况而定，而目前文献报道较少。我们报告一例20岁男性复发性侵袭性胸椎血管瘤病例，该病例导致进行性胸段脊髓病并伴有节段性后凸畸形，采用翻修整块脊椎切除术及使用可透射线器械进行多节段固定并重建脊柱进行治疗。
