Cotten A, Deramond H, Cortet B, Lejeune J P, Leclerc X, Chastanet P, Clarisse J
Department of Radiology, B Hospital, Lille, France.
AJNR Am J Neuroradiol. 1996 Jan;17(1):137-42.
To investigate the usefulness of preoperative percutaneous injections in vertebral hemangiomas.
Four patients presented with complicated vertebral hemangioma (spinal cord compression in three cases, intermittent spinal claudiction in one case). A three-part treatment was performed: initially, arterial embolization in three cases; 1 day later, percutaneous injections of methyl methacrylate into the vertebral body to strengthen it and of N-butyl cyanoacrylate into the posterior arch to optimize hemostasis during surgery; finally, the day after percutaneous injections, decompressive laminectomy and epidural hemangioma excision (when present).
Laminectomy was performed with minimal blood loss. The epidural component present in three cases was excised without any difficulty. The follow-up (average, 20 months) showed no evidence of vertebral collapse.
Percutaneous injections of methyl methacrylate and N-butyl cyanoacrylate might be useful before surgery for vertebral hemangiomas.
探讨术前经皮注射在椎体血管瘤治疗中的作用。
4例患者患有复杂椎体血管瘤（3例脊髓受压，1例间歇性跛行）。采用三部分治疗：首先，3例行动脉栓塞；1天后，经皮向椎体注射甲基丙烯酸甲酯以强化椎体，向后弓注射氰基丙烯酸正丁酯以优化手术中的止血；最后，在经皮注射后次日，行减压性椎板切除术及硬膜外血管瘤切除术（如有）。
椎板切除术中失血极少。3例存在的硬膜外成分均顺利切除。随访（平均20个月）显示无椎体塌陷迹象。
术前经皮注射甲基丙烯酸甲酯和氰基丙烯酸正丁酯可能对椎体血管瘤手术有用。
