Management of Cement Vertebroplasty in the Treatment of Vertebral Hemangioma

Abstract

Results: in all the patients a successful outcome has been observed with a complete resolution of pain symptom. extravertebral vascular cement leakage has been observed in 3 patients, without any clinical radicular syndrome onset due to the epidural diffusion. clinical and radiological follow-up showed stability of the treatment and absence of pain in all patients.Conclusion: percutaneous treatment with vertebroplasty for symptomatic vertebral hemangiomas is a valuable, less-invasive, and a quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of the vertebral body's fracture.

Algorithm of Treatment for Extensive Vertebral Hemangiomas According to Tomita Classification of Vertebral Tumors

“…These results are similar to those obtained by Miszczyk, 20% to 33.3% of reossification or fatty progression during their follow-ups [6]. Boschi et al assert that radiotherapy for VHs carries the risk of radiation-induced secondary sarcomas or the development of radionecrosis [9].…”

Vertebral hemangioma coincident with metastasis of colon adenocarcinoma

“…8,14,15 Compression is secondary to extradural extension of the VH or cortical bulging; rarely is it caused by hemorrhage in the vertebral canal or vertebral fracture. 1,6,8,9,15 There are reports on the rapid onset of signs of VH in the third trimester of pregnancy, suggesting that growth of the hemangioma can be stimulated by elevated secretion of estrogen with contribution of increased intraabdominal pressure. 3,8,9,15,16 To the best of our knowledge, spontaneous malignant transformation of VHs has not been reported.…”

Percutaneous vertebroplasty in symptomatic hemangioma versus osteoporotic compression fracture

“…There are no reports comparing the clinical results of PVP in the patients with OCF vs VH, but the efficacy of PVP for OCF or VH has been repeatedly reported 4121718. Kawanishi et al .…”

“…In the past, symptomatic VHs were usually treated by radiotherapy, selective arterial embolization, or surgical excision and stabilization. Nonetheless, all of these treatment modalities have documented hazardous complications16 and currently most specialists prefer to treat these lesions by PVP preceded with or without intralesional ethanol injection 1718…”