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Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review
Jiang, Liang1; Liu, Xiao Guang1; Yuan, Hui Shu2; Yang, Shao Min3; Li, Jie1; Wei, Feng1; Liu, Chen2; Dang, Lei1; Liu, Zhong Jun1
关键词Vertebral Hemangioma Neurological Deficit Spine Biopsy Vertebroplasty
刊名SPINE JOURNAL
2014-06-01
DOI10.1016/j.spinee.2013.07.450
14期:6页:944-954
收录类别SCI
文章类型Review
WOS标题词Science & Technology
类目[WOS]Clinical Neurology ; Orthopedics
研究领域[WOS]Neurosciences & Neurology ; Orthopedics
关键词[WOS]SPINAL-CORD COMPRESSION ; NATURAL-HISTORY ; FOLLOW-UP ; MANAGEMENT ; ETHANOL ; ALCOHOL
英文摘要

BACKGROUND CONTEXT: Vertebral hemangiomas (VHs) are called benign tumors but are actually just vascular malformations. The diagnosis and treatment for aggressive VHs is still controversial, due to their rarity.

PURPOSE: To evaluate the safety and efficiency of the present diagnostic methods and treatment choices.

STUDY DESIGN: A retrospective study of aggressive VHs with neurologic deficit.

PATIENTS SAMPLE: A total of 29 consecutive aggressive VH cases were diagnosed and treated in our department since 2001.

OUTCOME MEASURES: We routinely took anteroposterior and lateral spinal roentgenograms, computed tomography, and magnetic resonance images.

METHODS: Trocar biopsy is indicated in suspected malignant cases. Radiotherapy was usually our first choice if the neurologic deficit was mild or developed slowly. Surgery was indicated if the neurologic deficit was severe or developed quickly or if the radiotherapy was not effective.

RESULTS: This series included 12 males and 17 females, and the mean age at diagnosis was 44.0 years (range, 21-72 years). Ten patients had radiculopathy, 1 had cauda equina syndrome, and 18 cases had myelopathy. Twenty-one cases had lesions in the thoracic spine, 5 in the lumbar, and 3 in the cervical region. Eleven cases had untypical image findings, including five cases with pathologic vertebral fracture. The neurologic compression came from only epidural soft tumor mass in 18 cases, whereas it came from both bony compression and soft lesion in the other 11 cases. Ten cases had radiotherapy alone, but two failed and had surgery later. Twenty-one cases had surgery. In the 12 cases having surgical decompression without vertebroplasty, the average estimated blood loss was 1900 mL, and it was 1093 mL for the eight cases having decompression with vertebroplasty. The average follow-up was 51.1 months (range, 24-133 months). There was no recurrence in those cases with radiotherapy, whereas three had local recurrence in those six cases treated by surgical decompression alone without radiotherapy.

CONCLUSIONS: In aggressive VHs, epidural soft-tissue compression was usually the main reason for neurologic deficit. In cases with rapid progressive and/or severe myelopathy, posterior decompression and stabilization could be combined with intraoperative vertebroplasty to reduce blood loss. (C) 2014 Elsevier Inc. All rights reserved.

语种英语
WOS记录号WOS:000336412500019
引用统计
被引频次:21[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/51071
专题北京大学第三临床医学院_骨科
作者单位1.Peking Univ, Hosp 3, Dept Orthopaed, Beijing 100191, Peoples R China
2.Peking Univ, Hosp 3, Dept Radiol, Beijing 100191, Peoples R China
3.Peking Univ, Hlth Sci Ctr, Dept Pathol, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
Jiang, Liang,Liu, Xiao Guang,Yuan, Hui Shu,et al. Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review[J]. SPINE JOURNAL,2014,14(6):944-954.
APA Jiang, Liang.,Liu, Xiao Guang.,Yuan, Hui Shu.,Yang, Shao Min.,Li, Jie.,...&Liu, Zhong Jun.(2014).Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review.SPINE JOURNAL,14(6),944-954.
MLA Jiang, Liang,et al."Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review".SPINE JOURNAL 14.6(2014):944-954.
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