Abstract
BackgroundElderly patients with vertebral hemangiomas are rare and might require surgery. Thus, the choice of surgery for these lesions remains controversial because of the rarity of these lesions. This study aimed to analyze the clinical efficacy of the intraoperative injection of absorbable gelatin sponge mixed with cement followed by spinal decompression to treat the elderly with typical vertebral hemangiomas. The risk factors for hemangioma recurrence were investigated through a literature review.MethodsWe retrospectively analyzed 13 patients with typical aggressive hemangiomas between January 2009 and January 2016. Of these patients, 7 were treated with spinal decompression combined with intraoperative vertebroplasty (Group A), and 6 patients were treated with decompression with intraoperative vertebroplasty and absorbable gelatin sponge (Group B). The general data and perioperative data of the patients were compared. Patients were followed up for at least 3 years, and postoperative complications and recurrence rates were recorded and compared.ResultsAll patients had typical aggressive hemangiomas. The average age of all patients was 64.4 ± 3.3 years. The preoperative data did not differ significantly between the two groups (P > 0.05). The blood loss of groups A and B was 707.1 ± 109.7 ml and 416.7 ± 103.3 ml, respectively (P = 0.003) (P = 0.003), and the average surgery durations were 222 ± 47.8 min and 162 ± 30.2 min, respectively (P = 0.022). The average follow-up duration was 62 ± 19 months, and no cases of recurrence were found at the final follow-up assessment.ConclusionsMultimodal treatment significantly alleviated the clinical symptoms of elderly patients with typical aggressive vertebral hemangiomas. Intraoperative absorbable gelatin sponge injection is a safe and effective way to reduce blood loss and surgery duration.
Highlights
Patients with vertebral hemangiomas are rare and might require surgery
Xu et al BMC Musculoskeletal Disorders (2020) 21:125 compartment (Enneking stage 1; S1); (2) during the active stage, the tumor is contained within the spinal compartment and is accompanied by clinical symptoms (Enneking stage 2; S2); and (3) during the aggressive stage, the tumor expands out of the spinal compartment and is accompanied by clinical symptoms (Enneking stage 3; S3) [1]
Seven patients were treated with spinal decompression combined with intraoperative vertebroplasty (Group A), and six patients were treated with absorbable gelatin sponge combined with decompression and vertebroplasty (Group B) since 2013
Summary
Patients with vertebral hemangiomas are rare and might require surgery. Because S3 stage hemangiomas are rare with a high recurrence rate, simple surgical approaches remain controversial. Some experts [6, 7] recommended simple spinal decompression or tumor reductive surgery, which has low technical surgery requirements, causes little intraoperative blood loss, and is associated with fast postoperative recovery. The intraoperative blood loss is far more than that of decompression, and the incidence of bleeding-related complications after surgery is significantly increased. This procedure demands surgical skill and requires patients with higher health statuses [12]. Multimodal treatments include preoperative interventional embolization, spinal canal decompression or en bloc
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
