Symptomatic cervical vertebral hemangioma treated by percutaneous vertebroplasty

Pain Physician. 2013 Jul-Aug;16(4):E419-25.

Abstract

Background: Vertebral hemangioma (VH) is considered to be a benign lesion of bone with a rich vasculature. Most incidentally discovered hemangiomas are asymptomatic. Percutaneous vertebroplasty (PVP) has demonstrated efficacy in the treatment of symptomatic thoracic and lumbar VHs. To our knowledge, the reports concerning PVP on symptomatic cervical VHs are quite rare.

Objective: Our intent was to assess PVP as treatment for symptomatic cervical hemangiomas.

Study design: Prospective evaluation.

Setting: An inteventional pain management practice, single medical center.

Methods: Eight patients with symptomatic cervical VHs were enrolled between December 2008 and February 2012, all of whom underwent magnetic resonance imaging (MRI) of the cervical spine. The patients with 8 vertebral bodies of VHs were treated by using PVP. The clinical and radiological data were collected and analyzed. Postoperative outcomes were determined using a visual analog scale.

Results: Surgical levels include C3 (2 patients), C4 (3 patients), C5 (2 patients), and C6 (one patient). The average follow-up period was 27.4 months, with a minimum of 12 months. Mean operative time and x-ray exposure time were respectively 35 ± 7.1 minutes and 25 ± 7.7 seconds. The visual analogue scale for neck pain decreased significantly from 6.9 ± 0.6 preoperatively to 1.3 ± 0.5 (P < 0.01) on the second day after surgery, with a final score of 1.2 ± 0.5 (P < 0.01). Cement distribution was always diffuse and homogeneous. No cement leakage was observed in all cases except for 2 patients. There were no other major complications at the time of last follow-up evaluation.

Limitations: An observational clinical trial with a relatively small sample size.

Conclusion: Short-term results indicate that PVP appears to be an effective and safe treatment for symptomatic cervical VHs.

MeSH terms

  • Adult
  • Bone Cements / therapeutic use
  • Female
  • Follow-Up Studies
  • Hemangioma / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pain Management
  • Prospective Studies
  • Spinal Neoplasms / surgery*
  • Treatment Outcome
  • Vertebroplasty* / methods

Substances

  • Bone Cements