[Value of vertebroplasty combined with surgical decompression in the treatment of aggressive spinal angioma. Apropos of 3 cases].
Vertebral hemangiomas can cause difficult-to-treat neurological complications. We report our experience with three such cases. Patients no. 1 and 2 were females aged 64 and 71 years, respectively; patient no. 1 had a two-year history of weakness in the lower limbs and patient no. 2 had a five-month history of back pain. Both these patients had a pyramidal syndrome in the lower limbs. Patient no. 3 was a 61 year old male with a one-year history of left sciatica. Roentgenograms were suggestive of a hemangioma occupying the entire T8 (cases 1 and 2) or L5 (case 3) vertebra. Computed tomography and magnetic resonance imaging confirmed this diagnosis and showed that patients 1 and 2 had an anterior epidural hemangioma opposite T8 impinging on the spinal cord. In patients 1 and 2, treatment consisted in embolization of T8 followed by transpedicular injection of 6 cc of methylmethacrylate into the body of T8. One cubic centimeter of histoacryl was also injected in each lamina. The third patient had a similar vertebroplasty procedure without prior embolization since he had no epidural hemangioma. One patient (no. 1) developed intercostal neuralgia of several hours duration after the procedure. All three patients subsequently underwent laminectomy (T7-T8 with removal of the epidural hemangioma in cases 1 and 2, L5 in case 3). The pyramidal syndrome resolved within 15 days in patients 1 and 2; the nerve root pain resolved within 48 hours in patient 3.(ABSTRACT TRUNCATED AT 250 WORDS)
Cortet
B
B
Service de Rhumatologie, CHRU de Lille.
Cotten
A
A
Deprez
X
X
Deramond
H
H
Lejeune
J P
JP
Leclerc
X
X
Chastanet
P
P
Duquesnoy
B
B
Delcambre
B
B
D000368:Aged; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000008:administration & dosage / Q000031:analogs & derivatives; D015174:Epidural Neoplasms / Q000628:therapy; D005260:Female; D006391:Hemangioma / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007278:Injections, Spinal; D008159:Lumbar Vertebrae; D008297:Male; D008768:Methylmethacrylates / Q000008:administration & dosage*; D008875:Middle Aged; D013117:Spinal Cord Compression / Q000209:etiology / Q000628:therapy; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000601:surgery / Q000628:therapy*; D013904:Thoracic Vertebrae; D014014:Tissue Adhesives
D008768:Methylmethacrylates; D014014:Tissue Adhesives; D004659:Enbucrilate
Intérêt de la vertébroplastie couplée à une décompression chirurgicale dans le traitement des angiomes vertébraux agressifs. A propos de trois cas.