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Preoperative elastoplasty of aggressive vertebral hemangiomas in elderly patients: a new strategy for reducing intraoperative bleeding and complications.
Preoperative elastoplasty of aggressive vertebral hemangiomas in elderly patients: a new strategy for reducing intraoperative bleeding and complications.
- Source :
-
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 May; Vol. 33 (5), pp. 1921-1929. Date of Electronic Publication: 2024 Mar 15. - Publication Year :
- 2024
-
Abstract
- Purpose: Preoperative elastoplasty could be an alternative strategy for treating aggressive vertebral hemangiomas (VHs) in frail patients needing for spinal cord decompression, combining the advantages of embolization and vertebroplasty.<br />Methods: Three elderly patients with spinal cord compression from thoracic aggressive VHs underwent XperCT-guided percutaneous injection of silicone (VK100), filling the whole affected vertebra, followed by a decompressive laminectomy. At 12-months follow-up no recurrences, vertebral collapse or segmental kyphosis were noted at the CT scans, with patients reporting an improvement of preoperative neurological deficits, VAS and Smiley-Webster pain scale (SWPS) parameters.<br />Results: With its elastic modulus, non-exothermic hardening, and lower viscosity than PMMA, VK100 allowed a preoperative augmentation of the affected vertebral body, pedicles, and laminae without complications, with a controlled silicone delivery even in part of VH's epidural components thanks to XperCT-guidance.<br />Conclusion: When facing highly bony erosive VH encroaching the spinal canal, VK100 combines the advantages of embolization and vertebroplasty especially in elderly patients, permeating the whole VH's angioarchitecture, significantly reducing tumor.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Aged
Female
Male
Spinal Cord Compression surgery
Spinal Cord Compression etiology
Thoracic Vertebrae surgery
Thoracic Vertebrae diagnostic imaging
Blood Loss, Surgical prevention & control
Embolization, Therapeutic methods
Aged, 80 and over
Treatment Outcome
Laminectomy methods
Silicones
Decompression, Surgical methods
Hemangioma surgery
Hemangioma diagnostic imaging
Spinal Neoplasms surgery
Spinal Neoplasms complications
Spinal Neoplasms diagnostic imaging
Vertebroplasty methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0932
- Volume :
- 33
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
- Publication Type :
- Academic Journal
- Accession number :
- 38491218
- Full Text :
- https://doi.org/10.1007/s00586-024-08201-0