Journal article
Vertebral hemangiomas: Diagnosis and management. A single center experience
Clinical neurology and neurosurgery, Vol.190, pp.105745-105745
03/2020
DOI: 10.1016/j.clineuro.2020.105745
PMID: 32097829
Abstract
•Vertebral hemangiomas (VH) are often discovered incidentally.•Except in rare cases, biopsy is not needed for confirmation.•Observation for the asymptomatic lesion is appropriate.•For VH presenting with pain, vertebroplasty has been shown to be effective.•For VH with deficit or persistent pain, decompressive surgery is indicated.
Vertebral hemangiomas (VH) are common benign lesions involving the spine. Owing to the multiplicity of treatments, the management of VH has not always been consistent. In this retrospective review of a single center experience, indications and options available for the treatment of VH are outlined.
This is a retrospective review of 71 cases of VH managed at our institution between 2005 and 2019. Sixty of these cases were managed non-operatively, with 11 cases undergoing operative intervention. Of the 11 cases that underwent surgery, there were 2 cervical cases and 9 in the thoracic spine. Ten cases were symptomatic, and 1 incidental. Three patients presented with localized pain, and the remaining 7 had neurological deficit. Decompression with maximal resection of the hemangioma was undertaken in 10 cases, and vertebroplasty in 1.
Of the 60 patients who were managed non-operatively, 13 patients had presented with back/neck pain, with the remaining 47 patients being asymptomatic and diagnosed incidentally. Among the 13 symptomatic patients, all were offered surgical intervention for pain management, but given lack of severity of symptoms, all had opted for conservative approaches of pain control. In the 11 patients who underwent surgery, the preoperative diagnosis of VH was accurate in all but 1 case. There were 2 cervical cases treated with corpectomy. One patient was treated with vertebroplasty, and the remaining 8 with decompression. Radiation was used in 2 cases. Of the 10 patients undergoing decompression, 7 patients had improvement of the neurologic deficit, with resolution of pain in the remaining 3. None of our cases demonstrated deterioration.
VH are often discovered incidentally during evaluation of spinal pain. Except in rare cases, the diagnosis of VH is made correctly from the radiographic and MRI studies. Observation for the asymptomatic lesion is appropriate. For VH presenting with deficit or intractable pain, decompressive surgery is recommended. Radiation is appropriate in cases of recurrent VH.
Details
- Title: Subtitle
- Vertebral hemangiomas: Diagnosis and management. A single center experience
- Creators
- Nahom Teferi - Roy J. and Lucille A. Carver College of MedicineIbrahim Abukhiran - University of IowaJennifer Noeller - Roy J. and Lucille A. Carver College of MedicineLogan C Helland - Roy J. and Lucille A. Carver College of MedicineGirish Bathla - Roy J. and Lucille A. Carver College of MedicineEleanor C Ryan - Roy J. and Lucille A. Carver College of MedicineKirill V Nourski - Roy J. and Lucille A. Carver College of MedicinePatrick W Hitchon - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.190, pp.105745-105745
- DOI
- 10.1016/j.clineuro.2020.105745
- PMID
- 32097829
- NLM abbreviation
- Clin Neurol Neurosurg
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Publisher
- Elsevier B.V
- Language
- English
- Date published
- 03/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984256932002771
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