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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 919-925
DOI: 10.4103/ajns.AJNS_291_20
Original Article

Role of combined vertebroplasty and spinal decompression in the management of aggressive vertebral hemangiomas

Ebrahim Shamhoot
Department of Neurosurgery, Faculty of Medicine, Tanta University, Tanta
,
Ahmed Balaha
Department of Neurosurgery, Faculty of Medicine, Tanta University, Tanta
,
Ahmed Ganna
Department of Neurosurgery, Faculty of Medicine, Tanta University, Tanta
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Background: There are different surgical modalities designed to manage aggressive vertebral hemangioma (VH) that causes neurological symptoms. The selection of the best approach is still controversial. It is crucial to safely achieve neurological recovery with the elimination of the risk of recurrence. The combined use of surgical decompression and vertebroplasty is one of the surgical modalities that are used to manage these cases. Patients and Methods: From January 2012 to January 2019, nine patients with aggressive VH were retrospectively included in the study. All of them were operated upon using combined surgical decompression and vertebroplasty. We evaluated all the patients preoperatively, immediate postoperative, 1 month, and 12 months later. Clinical and radiological outcomes were assessed. Results: Affected spinal levels were dorsal in six cases and lumbar in three cases. There was no postoperative worsening of the preoperative neurological status. For the cases presented with sciatica, the mean VAS score has dropped from 8.33 preoperatively to 2.67 postoperatively. One month later, all of them are free from the radicular pain. For the cases presented with myelopathy, they regain their motor power in both lower limbs over a period of 4 weeks with a mean Nurick grade of 1.17. The postoperative radiological studies revealed near total occlusion of the VH with the maintenance of the vertebral body height. No clinical or radiological signs of spinal instability or recurrence are observed over the period of follow-up. Conclusions: The combined use of surgical decompression and vertebroplasty is considered a safe and effective modality in the management of aggressive VHs.

Key-words:

Bone cement - laminectomy - vertebral hemangioma - vertebroplasty

Financial support and sponsorship

Nil.




Publication History

Received: 12 June 2020

Accepted: 01 September 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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