Combined surgical and endovascular approach for treatment of aggressive vertebral haemangiomas

Daniel G. Eichberg, Robert M. Starke, Allan D Levi

Research output: Contribution to journalArticle

Abstract

Objective: To analyze the endovascular, surgical, and clinical outcomes of patients with aggressive vertebral haemangiomas (VHs) treated over a 17 year period. Methods: All medical, radiological, and surgical records were reviewed retrospectively. All patients underwent follow-up evaluation for pain and neurological outcome. Results: A total of 10 patients diagnosed with aggressive VHs causing neurologic compromise or pain underwent 13 operative procedures for tumour resection/stabilization. All but one patient underwent preoperative procedures to minimize intraoperative blood loss. Mean follow-up length was 26.3 months. Of eight patients presenting with neurological deficits, all improved postoperatively. The two patients presenting with pain reported improvement postoperatively. Two patients had new postoperative lower extremity weakness, both of which improved during follow-up. One patient experienced tumour recurrence at 1 year, requiring a second staged surgery. A second patient required a staged surgery for resection of multiple VHs. Seven patients had subtotal resections, two patients had gross total resections, and one patient had an en bloc resection of tumour. Conclusions: Combined preoperative embolization followed by aggressive tumour resection and spinal stabilization are safe and effective procedures for the treatment of aggressive VH causing symptomatic stenosis.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalBritish Journal of Neurosurgery
DOIs
StateAccepted/In press - Jul 5 2017

Fingerprint

Hemangioma
Therapeutics
Pain
Neoplasms
Preoperative Care
Operative Surgical Procedures
Nervous System
Lower Extremity
Pathologic Constriction
Recurrence

Keywords

  • embolisation
  • fusion
  • neoplasm
  • spine
  • surgery
  • Vertebral haemangioma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Combined surgical and endovascular approach for treatment of aggressive vertebral haemangiomas. / Eichberg, Daniel G.; Starke, Robert M.; Levi, Allan D.

In: British Journal of Neurosurgery, 05.07.2017, p. 1-8.

Research output: Contribution to journalArticle

@article{2b853152d97643448679a62a5ab5ec04,
title = "Combined surgical and endovascular approach for treatment of aggressive vertebral haemangiomas",
abstract = "Objective: To analyze the endovascular, surgical, and clinical outcomes of patients with aggressive vertebral haemangiomas (VHs) treated over a 17 year period. Methods: All medical, radiological, and surgical records were reviewed retrospectively. All patients underwent follow-up evaluation for pain and neurological outcome. Results: A total of 10 patients diagnosed with aggressive VHs causing neurologic compromise or pain underwent 13 operative procedures for tumour resection/stabilization. All but one patient underwent preoperative procedures to minimize intraoperative blood loss. Mean follow-up length was 26.3 months. Of eight patients presenting with neurological deficits, all improved postoperatively. The two patients presenting with pain reported improvement postoperatively. Two patients had new postoperative lower extremity weakness, both of which improved during follow-up. One patient experienced tumour recurrence at 1 year, requiring a second staged surgery. A second patient required a staged surgery for resection of multiple VHs. Seven patients had subtotal resections, two patients had gross total resections, and one patient had an en bloc resection of tumour. Conclusions: Combined preoperative embolization followed by aggressive tumour resection and spinal stabilization are safe and effective procedures for the treatment of aggressive VH causing symptomatic stenosis.",
keywords = "embolisation, fusion, neoplasm, spine, surgery, Vertebral haemangioma",
author = "Eichberg, {Daniel G.} and Starke, {Robert M.} and Levi, {Allan D}",
year = "2017",
month = "7",
day = "5",
doi = "10.1080/02688697.2017.1344619",
language = "English (US)",
pages = "1--8",
journal = "British Journal of Neurosurgery",
issn = "0268-8697",
publisher = "Informa Healthcare",

}

TY - JOUR

T1 - Combined surgical and endovascular approach for treatment of aggressive vertebral haemangiomas

AU - Eichberg, Daniel G.

AU - Starke, Robert M.

AU - Levi, Allan D

PY - 2017/7/5

Y1 - 2017/7/5

N2 - Objective: To analyze the endovascular, surgical, and clinical outcomes of patients with aggressive vertebral haemangiomas (VHs) treated over a 17 year period. Methods: All medical, radiological, and surgical records were reviewed retrospectively. All patients underwent follow-up evaluation for pain and neurological outcome. Results: A total of 10 patients diagnosed with aggressive VHs causing neurologic compromise or pain underwent 13 operative procedures for tumour resection/stabilization. All but one patient underwent preoperative procedures to minimize intraoperative blood loss. Mean follow-up length was 26.3 months. Of eight patients presenting with neurological deficits, all improved postoperatively. The two patients presenting with pain reported improvement postoperatively. Two patients had new postoperative lower extremity weakness, both of which improved during follow-up. One patient experienced tumour recurrence at 1 year, requiring a second staged surgery. A second patient required a staged surgery for resection of multiple VHs. Seven patients had subtotal resections, two patients had gross total resections, and one patient had an en bloc resection of tumour. Conclusions: Combined preoperative embolization followed by aggressive tumour resection and spinal stabilization are safe and effective procedures for the treatment of aggressive VH causing symptomatic stenosis.

AB - Objective: To analyze the endovascular, surgical, and clinical outcomes of patients with aggressive vertebral haemangiomas (VHs) treated over a 17 year period. Methods: All medical, radiological, and surgical records were reviewed retrospectively. All patients underwent follow-up evaluation for pain and neurological outcome. Results: A total of 10 patients diagnosed with aggressive VHs causing neurologic compromise or pain underwent 13 operative procedures for tumour resection/stabilization. All but one patient underwent preoperative procedures to minimize intraoperative blood loss. Mean follow-up length was 26.3 months. Of eight patients presenting with neurological deficits, all improved postoperatively. The two patients presenting with pain reported improvement postoperatively. Two patients had new postoperative lower extremity weakness, both of which improved during follow-up. One patient experienced tumour recurrence at 1 year, requiring a second staged surgery. A second patient required a staged surgery for resection of multiple VHs. Seven patients had subtotal resections, two patients had gross total resections, and one patient had an en bloc resection of tumour. Conclusions: Combined preoperative embolization followed by aggressive tumour resection and spinal stabilization are safe and effective procedures for the treatment of aggressive VH causing symptomatic stenosis.

KW - embolisation

KW - fusion

KW - neoplasm

KW - spine

KW - surgery

KW - Vertebral haemangioma

UR - http://www.scopus.com/inward/record.url?scp=85021893409&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021893409&partnerID=8YFLogxK

U2 - 10.1080/02688697.2017.1344619

DO - 10.1080/02688697.2017.1344619

M3 - Article

C2 - 28682125

AN - SCOPUS:85021893409

SP - 1

EP - 8

JO - British Journal of Neurosurgery

JF - British Journal of Neurosurgery

SN - 0268-8697

ER -