Comprehensive management of symptomatic and aggressive vertebral hemangiomas
Comprehensive management of symptomatic and aggressive vertebral hemangiomas
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DOI：
10.1016/j.nec.2007.09.010
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发表时间：
2008-01-01
影响因子：
2.6
通讯作者：
Ames, Christopher P.
中科院分区：
文献类型：
--
作者：
Acosta, Frank L., Jr.;Sanai, Nader;Ames, Christopher P.
保守的手术策略适用于大多数有症状的血管瘤，导致脊髓压迫而无不稳定或畸形。即使如此，对侵袭性椎体血管瘤伴周围椎体受累行栓塞后完全病灶内椎体切除术也是安全的。这样的脊椎切除术也可以防止血管瘤复发。经动脉栓塞而不减压是治疗疼痛性骨内血管瘤的有效方法。椎体成形术可用于改善疼痛症状，尤其是在无神经功能缺损的患者发生椎体压缩性骨折时，但在长期缓解疼痛方面效果较差。
Conservative surgical strategies are appropriate for most symptomatic hemangiomas causing cord compression without instability or deformity. Even so, complete intralesional spondylectomy following embolization of aggressive vertebral hemangiomas with circumferential vertebral involvement can be safely accomplished. Such a spondylectomy can also prevent recurrence of hemangiomas. Transarterial embolization without decompression is an effective treatment for painful intraosseous hemangiomas. Vertebroplasty is useful for improving pain symptoms, especially when vertebral body compression fracture has occurred in patients without neurological deficit, but is less effective in providing long-term pain relief.