SPIN-04 PAEDIATRIC SPINAL HEMANGIOMA PRESENTING WITH MYELOPATHY – HELPING A CHILD TO WALK AGAIN

Abstract

Abstract OBJECTIVES To highlight the adaptations in management of spinal tumour patients with available resources. To emphasize on the importance of neurorehabilitation post spinal tumour surgery. INTRODUCTION Vertebral/Spinal hemangiomas are benign lesions and often asymptomatic. They are more common in the thoracic spine where they may become symptomatic with varying presentations. Only a small percentage of these tumours are symptomatic, and this can be attributed to several factors which include epidural expansion of tumour tissue, expansion of bony elements, compression by vessels feeding or draining the lesion or rarely by compression fracture of the vertebra. CASE: This is a case of an 11-year-old girl who was managed at Parirenyatwa hospital. She had presented with a 2-month history of progressive backache associated with paraparesis and numbness in the legs. Had normal bowel and bladder control. No history of trauma or other comorbidities such as Tuberculosis, HIV, or known malignancies. An MRI done revealed a contrast enhancing extradural compressive mass at the level of T5, also involving parts of T5 vertebral body. RESULTS The patient was taken to theatre for thoracic spine decompression and biopsy, without instrumentation. Histology revealed that the lesion was a hemangioma. Patient recovered well over 2months on a corset and physiotherapy, 4 months later she was able to mobilise by herself and to run around. CONCLUSION The main stay of treating symptomatic vertebral hemangiomas remains surgery, with or without instrumentation. It is often rewarding though may be challenging to both the patient and the surgeon even in the best of centers. As exemplified by this case, we have managed to yield a satisfying outcome in the face of ‘adaptive’ measures. Neurorehabilitation enhanced the chances for the child to be able to walk again.