Surgical treatment of symptomatic vertebral haemangiomas.
OBJECTIVE
Vertebral haemangiomas are relatively common, benign vascular lesions; symptomatic ones that cause spinal cord compression are rare, however. Only 0.9-1.2% of all vertebral haemangiomas are symptomatic. The aim of the paper is to present indications, operative techniques and stabilization methods in patients with symptomatic vertebral haemangiomas.


METHODS
Clinical analysis included 7 patients treated between 1995 and 2007. There were 4 females and 3 males, aged 24 to 63 yrs (average age 44 yrs). Symptomatic vertebral haemangiomas were diagnosed on the basis of neuroradiological studies. Surgery was applied in all cases. Implantation of internal stabilization followed vertebral haemangioma resection.


RESULTS
Localization of vertebral haemangiomas included 1 case in the cervical, 5 cases in the thoracic and 1 case in the lumbar segment of the vertebral column. Symptoms of medulla compression were observed in 7 patients. Neurological symptoms were caused usually by hypertrophy or ballooning of the posterior cortex of the vertebral body into the vertebral canal. The anterior surgical approach was carried out in 2 cases, posterolateral in 3 cases and posterior in 2 cases. Spinal stability was secured by various implant systems and autogenic bone grafts. Bone defects in the vertebral body were filled with acrylic cement in 4 patients. In histological examinations, cavernous types were found in all patients. Neurological condition improved after the treatment in 5 patients.


CONCLUSIONS
No standard therapy exists for symptomatic thoracic vertebral haemangiomas. However, immediate surgical intervention is necessary in cases with acute compressive myelopathy before the symptoms become irreversible.
Katedra i Klinika Neurochirurgii i Neurotraumatologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu. Electronic address: klinikanch@op.pl.
Roman
R
Jankowski
Katedra i Klinika Neurochirurgii i Neurotraumatologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu.
Stanisław
S
Nowak
Katedra i Klinika Neurochirurgii i Neurotraumatologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu.
Ryszard
R
Zukiel
Pracownia Patomorfologii Neurochirurgicznej, Katedra Patomorfologii Klinicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu.
Janusz
J
Szymaś
Katedra i Klinika Neurochirurgii i Neurotraumatologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu.
Bartosz
B
Sokół
D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery; D005260:Female; D006391:Hemangioma / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013125:Spinal Neoplasms / Q000473:pathology* / Q000601:surgery*; D013131:Spine / Q000473:pathology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome