Surgical outcomes of vertebral body haemangioma with compressive symptoms -An Institutional experience

Abstract

Background: Vertebral body (VH) hemangiomas are mostly asymptomatic, symptomatic one are difficult to manage and which treatment modality is ideal is still controversial. We would like to present our institutional experience in managing aggressive VH by surgical decompression and use of intraoperative alcohol ablation.

Objective: To know the role of intra-operative intra-lesional Ethanol injection, surgical decompression and stabilization of affected segment using Titanium Polyaxial screw and rods.

Methods:  A Prospective longitudinal study done at IGIMS Patna in Symptomatic VH with compressive myelopathy.

Operative plan - Bilateral Transpedicular Intralesional absolute alcohol (<1% hydrated ethyl alcohol) injection, laminectomy decompression and stabilisation of affected segment using     polyaxial Titanium pedicle screws and rod.

Results: In this study there were  19 patients in which 10 were females and 9 were males presented with back pain, myelopathy and sphincter dysfunction, having Pre-operative American Spinal Injury Association (ASIA) scores: A (9), B (5), C (3), D (2) and E (0).Mean surgical time was  120+30minutes , Mean blood loss- was 250+50 cc and mean amount of absolute alcohol used was 6+5 ml , Post op all patients improved on follow up with Follow-up ASIA scores were  E (9), D (5), B (3) & C (2).

Conclusions: The use of intraoperative ethanol as  an embolizing agent, laminectomy decompression and stabilization using screw and rod for symptomatic VH seems to be ideal treatment modality in resource poor  Country like India.