title: Minimally invasive decompression and stabilisation for extensive haemangiomas of lumbar spine.
abstract: BACKGROUND
  Vertebral haemangiomas are a common incidental finding and are largely asymptomatic. Extensive haemangiomas of the spine causing neurological deficits are exceedingly rare. Traditional open surgical approaches in these cases can be complicated by life-threatening blood loss.
  We describe 2 patients (ages 27 and 53 years) who presented with severe back pain and lower limb weakness. Radiological investigations revealed very extensive lesions of the L1 and L4 vertebral bodies, respectively, with severe narrowing of the lumbar canal. After selective embolisation of the spinal arterial feeders, both patients underwent a posterior decompression, vertebroplasty, and bilateral pedicle screw fixation in a minimally invasive fashion. Blood loss was minimal and a rapid clinical recovery was seen.
  
  
  CONCLUSIONS
  Combinations of embolisation, vertebroplasty and minimally invasive posterolateral instrumentation are treatment strategies that can be used to treat extensive vertebral haemangiomas presenting with neurological deficits.
authors.affiliation: Department of Neurosurgery, Greater Manchester Neurosciences Centre, Salford Royal Foundation Trust, Manchester, UK. kanna.gnanalingham@srft.nhs.uk
authors.forename: K K
authors.initials: KK
authors.lastname: Gnanalingham
authors.forename: M B
authors.initials: MB
authors.lastname: Afridi
authors.forename: A
authors.initials: A
authors.lastname: Abou-Zeid
authors.forename: A
authors.initials: A
authors.lastname: Herwadkar
mesh_terms: D000328:Adult; D001863:Bone Screws; D019299:Decompression, Surgical; D006391:Hemangioma / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013123:Spinal Fusion / Q000295:instrumentation; D013125:Spinal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty