title: Two-stage surgical management of multilevel symptomatic thoracic haemangioma using ethanol and iliac crest bone graft.
abstract: This article presents a 56-year-old obese female who presented with back pain and progressive weakness in her lower limbs for three months. She was bed-ridden for one week before reporting to our hospital. Plain radiographs showed vertical striations in multiple vertebrae classical of haemangioma. Magnetic resonance imaging (MRI) spine revealed multiple thoracic and lumbar vertebral haemangiomas. Extra osseous extension of haemangioma at T12 was causing spinal cord compression. Two-stage surgery was performed with absolute alcohol (ethanol) injection followed by pedicle screw fixation and decompression with tricortical iliac crest bone graft into the vertebral body. Postoperatively rapid neurological improvement was seen. After three weeks, she could walk independently. One year later, computed tomography showed complete incorporation of bone graft and maintained vertebral body height. MRI showed complete resolution of the cord edema at T12. These findings indicated diminished vascularity of the tumor.
authors.affiliation: Department of Orthopaedics, Kamineni Institute of Medical Sciences, Narketpally, India.
authors.forename: Devanand
authors.initials: D
authors.lastname: Degulmadi
authors.affiliation: Department of Orthopaedics, Kamineni Institute of Medical Sciences, Narketpally, India.
authors.forename: Venkatramana
authors.initials: V
authors.lastname: Brahmajoshyula
authors.affiliation: Department of Orthopaedics, Kamineni Institute of Medical Sciences, Narketpally, India.
authors.forename: Shivanand
authors.initials: S
authors.lastname: Mayi
authors.affiliation: Department of Orthopaedics, Kamineni Institute of Medical Sciences, Narketpally, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Teegala
keywords: Ethanol; Haemangioma; Tricortical iliac crest bone graft; Two stage surgery