ABSTRACT
Epithelioid hemangioendothelioma is a recently described, rare vasoformative vascular tumor of variable biological behavior. Its principal sites of occurrence are soft tissues, liver, lung, and bone. There have been no formal case reports of this tumor occurring in the vertebral column, and there are no reports in the literature of surgical treatment for vertebral epithelioid hemangioendothelioma. We present a case of primary vertebral epithelioid hemangioendothelioma occurring in the L2 vertebral body. Surgical treatment, pathological findings, imaging characteristics, and a review of the literature are presented.
Subject(s)
Hemangioendothelioma, Epithelioid/diagnosis , Hemangioendothelioma, Epithelioid/pathology , Lumbar Vertebrae , Spinal Neoplasms/diagnosis , Spinal Neoplasms/pathology , Adult , Female , Hemangioendothelioma, Epithelioid/surgery , Humans , Magnetic Resonance Imaging , Spinal Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
Nineteen cases of traumatic spondylolisthesis of the axis, including 13 standard hangman's fractures and 6 anterolistheses of the C2 vertebral body associated with Effendi's atypical hangman's fractures, were studied. Unlike the standard Effendi Type I or Type II fractures, atypical hangman's fractures, occurring through the posterior aspect of the vertebral body with unilateral or bilateral continuity of the posterior cortex or pedicle, routinely narrow the spinal canal because of the fracture pattern and degree of subluxation. These atypical C2 injuries were more frequent and more often accompanied by paralysis (33%) than was previously anticipated. Because of their greater potential for neurologic compromise, it is essential that these fractures be recognized as distinct from standard Types I and II C2 fractures. Larger series should clarify both the true incidence of paralysis and long-term results from these unique C2 injuries.
Subject(s)
Axis, Cervical Vertebra/injuries , Joint Dislocations/classification , Spinal Fractures/classification , Adult , Female , Humans , Incidence , Joint Dislocations/complications , Joint Dislocations/epidemiology , Male , Quadriplegia/etiology , Spinal Fractures/complications , Spinal Fractures/epidemiology , Spondylolisthesis/etiologyABSTRACT
Twenty-two patients with burst fractures in this mechanically and neurologically distinct region (T11-L2) were studied at injury and after acute surgical reduction and stabilization (antikyphosis and ligamentotaxis concept). Canal compromise averaged 42% (10-82%) before surgery, and at follow-up 14% (0-46%), segmental kyphosis 15 degrees (4 degrees-27 degrees) and 3 degrees (0 degree-15 degrees), and vertebral segment height 62% (41-85%) and 86% (60-100%), respectively. Incomplete patients gained an average of 1.8 Frankel subgrades. The described treatment can predictably recanalize the spine, correct deformity, and stabilize neurologic compromise. A significant correlation between postoperative neurologic status and the radiographic criteria under study could not be established.
