Chen Qing-Quan, Wang Hong-Shen, Wang Hui, Chen Jin-Shui, Xiao Jie, Yang Xiu
Spinal Ward, The 900th Hospital of PLA Joint Logistic Support Force, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China.
Front Surg. 2025 Sep 11;12:1647623. doi: 10.3389/fsurg.2025.1647623. eCollection 2025.
To evaluate the clinical outcomes of a multidisciplinary approach for the treatment of aggressive vertebral hemangioma with acute cauda equina compression.
A 37-year-old female patient with aggressive vertebral hemangioma presented with sudden loss of muscle strength in both lower limbs (grade I-II) and difficulty in urination and defecation. Magnetic resonance imaging and digital subtraction angiography confirmed a vascular tumor within and around the L4 vertebra, causing cauda equina compression. The treatment involved staged vascular embolization (of the third lumbar artery and branches of the sacral artery) combined with L4 vertebroplasty, laminectomy decompression, and pedicle screw fixation. Postoperative pain was immediately relieved. After 3 months of rehabilitation, muscle strength in both lower limbs recovered to grade 3, with significant improvement in spontaneous urination and defecation. Imaging studies showed complete relief of spinal canal compression.
Aggressive spinal hemangioma may require multidisciplinary collaboration, and staged vascular embolization combined with spinal decompression and stabilization surgery can effectively improve neurological function. Early intervention is crucial for achieving favorable outcomes.
评估多学科方法治疗侵袭性椎体血管瘤伴急性马尾神经受压的临床疗效。
一名37岁患有侵袭性椎体血管瘤的女性患者，出现双下肢突然肌力丧失（I-II级）及排尿和排便困难。磁共振成像和数字减影血管造影证实L4椎体及其周围存在血管性肿瘤，导致马尾神经受压。治疗包括分期血管栓塞（第三腰动脉和骶动脉分支）联合L4椎体成形术、椎板切除术减压和椎弓根螺钉固定。术后疼痛立即缓解。经过3个月的康复，双下肢肌力恢复到3级，自主排尿和排便有显著改善。影像学检查显示椎管压迫完全解除。
侵袭性脊柱血管瘤可能需要多学科协作，分期血管栓塞联合脊柱减压和稳定手术可有效改善神经功能。早期干预对于取得良好疗效至关重要。
