Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/63619
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Type: Journal article
Title: Vertebral hemangioma: An important differential in the evaluation of locally aggressive spinal lesions
Author: Alexander, J.
Meir, A.
Vrodos, N.
Yau, Y.
Citation: Spine, 2010; 35(18):E917-E920
Publisher: Lippincott Williams & Wilkins
Issue Date: 2010
ISSN: 0362-2436
1528-1159
Statement of
Responsibility: 
Justin Alexander, Adam Meir, Nikitas Vrodos and Yun-Hom Yau
Abstract: Study Design. A case report and a discussion of recent published data. Objective. To highlight the importance of vertebral hemangioma (VH) as a differential diagnosis in the evaluation of locally aggressive spinal lesions. Summary of Background Data. VH commonly occur as incidental findings, however, locally aggressive VH have been described. Difficulties in diagnosing these lesions are well reported and relate to changes in fat content causing uncharacteristic appearances on imaging. The management options for these lesions include a combination of observation, embolization, sclerotherapy, surgical decompression, or stabilization and radiotherapy. Methods. A 45-year-old patient who was previously well presented with back pain and rapidly progressive paraparesis. Imaging confirmed the presence of an extensive lesion centered within the right T3 vertebral pedicle with intrusion into the spinal canal. Urgent surgical decompression was undertaken and was complicated by extensive intraoperative hemorrhage requiring massive transfusion. Results. Histologically, the lesion was shown to be a cavernous VH with no evidence of malignancy. Following radiation oncology review, he was offered adjuvant radiotherapy to minimize the risks of recurrence. He achieved a near full neurologic recovery within 2 weeks and had a full recovery by 12 months. Conclusion. VH should be considered in the evaluation of locally aggressive spinal lesions. Angiography is a useful adjunct in the evaluation of these lesions, both as a diagnostic and therapeutic tool. After diagnosed correctly a wide range of treatment options exist that may prevent the patient from undergoing major surgical resection and reconstruction procedures, which may be associated with high rates of morbidity.
Keywords: vertebral haemangioma
myelopathy
diagnosis
management
Rights: © 2010 Lippincott Williams & Wilkins, Inc.
DOI: 10.1097/BRS.0b013e3181ddfb24
Appears in Collections:Aurora harvest
Orthopaedics and Trauma publications

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