Percutaneous vertebroplasty for symptomatic hemangiomas in thoracic or lumbar vertebrae / 中国微创外科杂志

ABSTRACT

Objective To study clinical results of percutaneous vertebroplasty(PVP) for the treatment of symptomatic vertebral hemangiomas.Methods A total of 10 patients with vertebral hemangioma (thoracic vertebrae,6 patients;lumbar vertebrae,4 patients) were treated from December 2002 to April 2005.Under the guidance of digital subtraction angiography(DSA),a needle was advanced into the vertebral body via a unipedicular or bipedicular approach.The preparation of polymethylmethacrylate(PMMA) was mixed with 3 doses of powder,2 doses of liquid,and 1 dose of contrast until a doughy,cohesive consistency similar to toothpaste was obtained.Then the PMMA cement was injected into the vertebral body by using a high-pressure plunger.The total injection volume ranged 4~6 ml(mean,4.8 ml) in the thoracic vertebrae and 5~8 ml(mean,6.0 ml) in the lumbar vertebrae.Results The procedure was completed smoothly in all 10 patients.The operation time was 25~60 min(mean,39.5 min) and the intraoperative blood loss was 10~50 ml(mean,19.6 ml).No incidence of cement leakage or pulmonary embolism occurred.The 10 patients were followed for 2~30 months(mean,18 months).In 9 patients,free of signs and symptoms was achieved and no vertebral compression fracture or recurrence of hemangioma was observed.One patient with L_3 hemangioma still complained of mild and paroxysmal loin pain at 1 year after procedure,but the patient's normal activities were unaffected and no nervous dysfunction was found.Conclusions Percutaneous vertebroplasty is a safe and effective treatment for symptomatic vertebral hemangiomas.