Treatment of Vertebral Hemangiomas With Absolute Alcohol (Ethanol) Embolization, Cord Decompression, and Single Level Instrumentation: A Pilot Study

doi:10.1227/NEU.0b013e3181fc60e9

Paper

Treatment of Vertebral Hemangiomas With Absolute Alcohol (Ethanol) Embolization, Cord Decompression, and Single Level Instrumentation: A Pilot Study

Published Jan 1, 2011 · N. K. Mishra

Neurosurgery

Q1 SJR score

28

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1

Influential Citations

Full textSemantic Scholar

Abstract

BACKGROUND:Vertebral hemangiomas (VH) are the most common lesions of the vertebral column. OBJECT:To evaluate the role of intraoperative ethanol embolization, surgical decompression, and instrumented fusion in VH presenting with myelopathy. METHODS:This is was a prospective study of single-level symptomatic VH with cord compression. Exclusions were as follows: pathological fractures, deformity, or multilevel pathologies. Surgery consisted of intraoperative bilateral pedicular absolute alcohol injection and laminectomy at the level of pathology followed by a short-segment instrumented fusion using pedicle screws. RESULTS:Ten patients (mean, 26.8 ± 18.11; range, 10-68 years; 8 females) were treated with use of this technique. Clinical features included myelopathy with motor and sensory involvement in all (4 paraplegic), sphincter involvement (8), and severe local pain (5). The preoperative American Spinal Injury Association (ASIA) scores were A (3), B (1), and C (6). All had pan vertebral body VH with severe cord compression. The mean surgical time was 102 ± 22 minutes; average blood, 296 ± 90.82 mL. Mean amount of absolute alcohol injected was 12.6 ± 4.7 mL (1 requiring 25 mL). Immediate embolization was achieved in all patients allowing laminectomy and soft-tissue hemangioma removal. Postsurgery, all patients showed improvement (sphincters improved in 4) at a follow-up ranging 12 to 26 months (transient neurological deterioration in 1). Postsurgery ASIA scores were D (5) and E (5) at last follow-up. Two patients showed evidence of bone sclerosis on follow-up CT scans at 1.2 and 1.5 years. CONCLUSION:This procedure seems to be a safe, efficient method to treat VH with severe cord compression. It seems to serve the purpose of providing embolization, cord decompression, and rigid fusion at the same sitting.

Observational Study

Study Snapshot

Ethanol embolization, cord decompression, and instrumented fusion are a safe and efficient method for treating vertebral hemangiomas with severe cord compression.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Treatment of Vertebral Hemangiomas With Absolute Alcohol (Ethanol) Embolization, Cord Decompression, and Single Level Instrumentation: A Pilot Study

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References

Management of painful vertebral hemangiomas with kyphoplasty: a report of two cases and a literature review.

Balloon kyphoplasty effectively relieves pain in painful vertebral hemangiomas, offering fewer procedural risks compared to traditional treatments.

Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

Vertebroplasty is a valuable, mini-invasive, and quick method for treating aggressive and symptomatic vertebral hemangiomas, providing complete and lasting pain relief without fractures of adjacent or distant vertebral bodies.

Preoperative Onyx Embolization of Aggressive Vertebral Hemangiomas

Onyx embolization effectively devascularizes aggressive vertebral hemangiomas, providing rapid and visible preoperative tumor devascularization.

Spinal cord compression due to vertebral hemangioma.

Multiple vertebral hemangiomas can cause spinal cord compression, but radiotherapy effectively improves symptoms in this patient.

Management of symptomatic vertebral hemangiomas: review of 13 patients.

CT guided percutaneous transpedicular injection of absolute alcohol shows promising results in managing symptomatic vertebral hemangiomas, but long-term follow-up is necessary.

Efficacy and Safety of Ethanol Injections in 18 Cases of Vertebral Hemangioma: A Mean Follow-Up of 2 Years

Intralesional alcohol injections are a safe technique for treating vertebral hemangiomas, but careful technique is needed to avoid complications.

Symptomatic vertebral hemangiomas: treatment by means of direct intralesional injection of ethanol.

Direct injection of ethanol into symptomatic vertebral hemangiomas is an effective and safe treatment, provided the dose is less than 15 mL.

Brown-Sequard syndrome after management of vertebral hemangioma with intralesional alcohol. A case report.

Intralesional alcohol injection is not a safe technique for managing vertebral hemangiomas with spinal cord compression due to the risk of Brown-Sequard syndrome.

Intralesional injection of absolute alcohol into vertebral hemangiomas: a new treatment option?

Intralesional injection of absolute alcohol into vertebral hemangiomas may offer a new treatment option for patients with symptomatic vertebral hemangiomas.

Citations

Surgical Options for Aggressive Vertebral Hemangiomas：A case series, literature review and treatment recommendations

Decompression plus vertebroplasty (VP) achieves good tumor control and reduces surgical complications, with postoperative radiotherapy effectively preventing tumor recurrence in aggressive vertebral hemangiomas.

Surgical management of symptomatic vertebral hemangiomas: A single institution experience and literature review.

Surgical management of symptomatic vertebral hemangiomas should include surgery, radiotherapy, and vertebroplasty, with a focus on minimizing spinal cord compression and nerve root damage.

A case series for Enneking Stage III vertebral hemangiomas management, outcome, and literature review

All 11 patients with Enneking Stage III vertebral hemangiomas showed full neurological recovery and clinical improvement regardless of treatment variety, suggesting a need for a comprehensive treatment protocol.

Management of myelopathy due to anterior soft tissue compression in vertebral hemangioma.

Direct transpedicular ethanol embolization, laminectomy, and short-segment instrumented fusion effectively resolves extraosseous soft tissue and improves myelopathy in vertebral hemangiomas causing spinal canal compromise.

Application of Absolute Alcohol in the Treatment of Traumatic Intracranial Hemorrhage via Interventional Embolization of Middle Meningeal Artery

Absolute alcohol embolization of the middle meningeal artery effectively treats acute epidural hematoma and chronic subdural hematoma, providing symptomatic relief without complications.