title: Comprehensive management of symptomatic and aggressive vertebral hemangiomas.
abstract: Conservative surgical strategies are appropriate for most symptomatic hemangiomas causing cord compression without instability or deformity. Even so, complete intralesional spondylectomy following embolization of aggressive vertebral hemangiomas with circumferential vertebral involvement can be safely accomplished. Such a spondylectomy can also prevent recurrence of hemangiomas. Transarterial embolization without decompression is an effective treatment for painful intraosseous hemangiomas. Vertebroplasty is useful for improving pain symptoms, especially when vertebral body compression fracture has occurred in patients without neurological deficit, but is less effective in providing long-term pain relief.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, R505 Parnassus Avenue, Room M-779, San Francisco, CA 94143-0112, USA. acostaf@post.harvard.edu
authors.forename: Frank L
authors.initials: FL
authors.lastname: Acosta
authors.forename: Nader
authors.initials: N
authors.lastname: Sanai
authors.forename: John H
authors.initials: JH
authors.lastname: Chi
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Dowd
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chin
authors.forename: Tarik
authors.initials: T
authors.lastname: Tihan
authors.forename: Dean
authors.initials: D
authors.lastname: Chou
authors.forename: Philip R
authors.initials: PR
authors.lastname: Weinstein
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Ames
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology / Q000503:physiopathology; D004621:Embolization, Therapeutic / Q000379:methods / Q000592:standards; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006391:Hemangioma / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods / Q000592:standards; D013117:Spinal Cord Compression / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013125:Spinal Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D013131:Spine / Q000098:blood supply / Q000473:pathology* / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods / Q000592:standards