A novel surgical technique for aggressive vertebral hemangiomas

Neurocirugia (Astur : Engl Ed). 2019 Sep-Oct;30(5):233-237. doi: 10.1016/j.neucir.2018.08.003. Epub 2018 Sep 25.
[Article in English, Spanish]

Abstract

Vertebral hemangiomas are relatively common, but those causing spinal cord compression are rare. A 19-year-old male presented with thoracic back pain. The neurologic examination was normal and radiological examinations demonstrated an aggressive vertebral hemangioma centered within the T11 vertebral body. Damaged vertebral bone and soft tissue components of the mass were observed in the epidural space. Surgery was performed using a new technique involving radiofrequency ablation, injection of a hemostatic agent (FLOSEAL, Baxter, USA), and bone autograft placement in the affected vertebral body. There were no complications intra- or postoperatively, and the patient's back pain resolved completely during the postsurgical period. Bleeding is a serious issue in cases of aggressive vertebral hemangioma. This new technique provides improved bleeding control and strengthens the affected vertebra through autograft placement.

Keywords: Ablación por radiofrecuencia; Agente hemostático; Aggressive vertebral hemangioma; Autograft; Autoinjerto; Hemangioma vertebral agresivo; Hemostatic agent; Radiofrequency ablation.

Publication types

  • Case Reports

MeSH terms

  • Back Pain / etiology
  • Bone Screws
  • Bone Transplantation
  • Decompression, Surgical / methods*
  • Gelatin Sponge, Absorbable
  • Hemangioma / complications
  • Hemangioma / diagnostic imaging
  • Hemangioma / surgery*
  • Hemostasis, Surgical / methods
  • Humans
  • Laminectomy
  • Magnetic Resonance Imaging
  • Male
  • Radiofrequency Ablation / methods*
  • Radiography, Interventional
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / surgery*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery*
  • Transplantation, Autologous
  • Vertebroplasty / methods*
  • Young Adult

Substances

  • FloSeal Matrix