Surgical treatment of lumbar canal stenosis with concomitant aggressive vertebral haemangioma

Authors

  • Ankur D. Kariya Department of Orthopaedics, MGIMS, Sewagram, Wardha, Maharashtra, India
  • Pramod A. Jain Department of Orthopaedics, MGIMS, Sewagram, Wardha, Maharashtra, India
  • Kisan R. Patond Department of Orthopaedics, MGIMS, Sewagram, Wardha, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20202699

Keywords:

Atypical hemangioma, Vertebroplasty, Spinal canal stenosis

Abstract

Vertebral hemangiomas are the most common benign spinal tumours which are asymptomatic, slow-growing benign vascular malformations. They usually involve the vertebral body. However, the involvement of the posterior elements may present with spinal cord compression. Vertebral hemangiomas exist as a continuum of manifestations and lesions ranging from the common asymptomatic forms to rare compressive lesions. Presence of multilevel spinal canal stenosis along with an atypical vertebral hemangioma with cord is a rare condition and represents a treatment challenge. We report a case of spinal canal stenosis at L2 to L4 spinal levels along with an atypical vertebral hemangioma at L3 vertebra with extension to bilateral pedicles. This tumour caused neurological manifestations and was surgically treated with posterior decompression and stabilization with transpedicular screws and rods along with vertebroplasty for the hemangioma. Presence of an atypical hemangioma with co-existing spinal canal stenosis is a rare indication of spinal fusion. Vertebroplasty for the treatment of hemangioma in such cases is imperative.

References

Fox MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg. 1993;78(1):36-45.

Heiss JD, Doppman JL, Oldfield EH. Relief of spinal cord compression from vertebral hemangioma by intralesional injection of absolute ethanol. New England J Med. 1994;331(8):508-11.

Graham JJ, Yang WC. Vertebral hemangioma with compression fracture and paraparesis treated with preoperative embolization and vertebral resection. Spine. 1984;9(1):97-101.

Hurley M, Gross B, Surdell D, Shaibani A, Muro K, Mitchell C, et al. Preoperative Onyx embolization of aggressive vertebral hemangiomas. Am J Neuroradiology. 2008;29(6):1095-7.

Postacchini F, Cinotti G, Perugia D, Gumina S. The surgical treatment of central lumbar stenosis. Multiple laminotomy compared with total laminectomy. J Bone Joint Surg British Volume. 1993;75(3):386-92.

Nguyen J, Djindjian M, Gaston A, Gherardi R, Benhaiem N, Caron J, et al. Vertebral hemangiomas presenting with neurologic symptoms. Surg Neurology. 1987;27(4):391-7.

Cross J, Antoun N, Laing R, Xuereb J. Imaging of compressive vertebral haemangiomas. European Radiology. 2000;10(6):997-1002.

Ide C, Gangi A, Rimmelin A, Beaujeux R, Maitrot D, Buchhei F, et al. Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate. Neuroradiology. 1996;38(6):585-9.

Syrimpeis V, Vitsas V, Korovessis P. Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: Case report and review of literature. J Spinal Cord Med. 2014;37(2):237-42.

Laredo JD, Hamze B. Complications of percutaneous vertebroplasty and their prevention. Skeletal Radiology. 2004;33(9):493-505.

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Published

2020-06-23

Issue

Section

Case Reports