Баллонная кифопластика в хирургическом лечении агрессивных гемангиом позвоночника (обзор литературы)

S.A Miziurov,V.B Arsenievich,A.V Papaev,V.V Ostrovskij,A.V Zaretskov,S.V Likhachev,V.V Zaretskov

doi:10.18019/1028-4427-2021-27-6-821-826

Abstract

Introduction Aggressive vertebral hemangiomas occur in 10–11.5 % of the working-age population that determines social significance of the disease. Percutaneous vertebroplasty technique is normally used for the treatment of aggressive spinal hemangiomas. Cement leakage is the most common complication during vertebroplasty (40–87. 5 %). Balloon kyphoplasty is associated with a low incidence of cement leakage. Objective We aimed to analyze literature and summarize information on balloon kyphoplasty used to treat aggressive spinal hemangiomas. Material and methods The original literature search was conducted on key resources including PubMed and GoogleScholar. Literature searches included both Russian and English studies based on keywords. Results and discussion The article presents the main results of balloon kyphoplasty used as a standalone procedure and in combination with other methods of surgical treatment of aggressive spinal hemangiomas. The use of balloon kyphoplasty was shown to reduce the risk of extraspinal cement leakage. However, this aspect is represented by a small number of scientific publications in the current medical literature that emphasizes the relevance of the topic raised. Conclusion Despite the variety of available treatment options, the optimal management strategy remains controversial for aggressive forms of vertebral hemangiomas. There are no well-defined criteria and indications reported recently to be included into a well-structured algorithm for of balloon kyphoplasty in the treatment of aggressive spinal hemangiomas, and therefore the debatable questions need further investigation.

Highlights

Aggressive vertebral hemangiomas occur in 10–11.5 % of the working-age population that determines social significance of the disease
Based on the results of the patients, the authors concluded that Balloon kyphoplasty (BK) can reduce the risk of extravertebral migration of bone cement compared to Percutaneous vertebroplasty (PV) due to the formation of an "alternative" internal cavity in the body of the affected vertebra, thereby confirming the findings reported by Hadjipavlou A. et al (2007) and Zapalowicz K. et al (2008)
BK can be useful for aggressive Spinal hemangioma (SH) that is associated with a cortical defect of the body of the affected vertebra taking into account potential complications [35]

Summary

Introduction

Aggressive vertebral hemangiomas occur in 10–11.5 % of the working-age population that determines social significance of the disease. Significant aggressive SH occur in 0.9–4 % of cases [8]. There are several criteria presented by different authors to include 6 to 10 signs of aggressive hemangiomas to establish the diagnosis of "aggressive hemangioma" [2]. N. et al (2012) offered a scale for assessing the aggressiveness of spinal hemangiomas that includes 9 radiological and clinical criteria with a score from 1 to 5 to establish the aggressiveness of a hemangioma [11]. Aggressive SH are accompanied by intracanal growth in 1 % of cases with resultant spinal canal stenosis and narrowing of intervertebral foramen and a gradual increase in neurological symptoms (radicular syndrome, paraesthesia, conductive sensory disorders, paresis and paralysis) [2, 12, 13]. Gradual restructuring of the bone tissue of the vertebral body occurs and can lead to its pathological fracture [14, 15, 16]

Results

Discussion

Conclusion