TY - JOUR
T1 - Integrated treatment of a lumbar vertebral hemangioma with spinal stenosis and radiculopathy
T2 - A case report and a review of the literature
AU - Samade, Richard
AU - Malik, Azeem
AU - Jain, Nikhil
AU - Scharschmidt, Thomas
AU - Yu, Elizabeth
N1 - Publisher Copyright:
© 2020 Journal of Craniovertebral Junction and Spine | Published by Wolters Kluwer-Medknow.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - We describe a comprehensive, multidisciplinary treatment approach for lumbar vertebral hemangiomas (VHs) with spinal stenosis and radiculopathy. A 59-year-old female presented with 1 year of pain predominantly in the lower back, with pain in the left buttock and proximal left anterior thigh as well and magnetic resonance imaging of the lumbar spine demonstrated lumbar scoliosis and an L3 vertebral lesion suspicious for hemangioma. A computed tomography guided biopsy was done, which supported the diagnosis. Definitive treatment entailed preoperative angiography and embolization, followed by L3 laminectomy, right L3 pedicle resection, partial L3 corpectomy, L3 vertebral cement augmentation, and L1 to L5 instrumented fusion. By 1-year postoperatively, the patient reported no radicular pain and only mild groin pain attributed to left hip degenerative joint disease. Radiographs 1-year postoperatively confirmed the stability of the instrumented posterior fusion and a magnetic resonance imaging with and without contrast confirmed no VH recurrence. A comprehensive and multidisciplinary approach for the treatment of VHs with neurological symptoms or signs is presented. This approach is recommended to maximize lesion removal, ensure biomechanical stability, and minimize recurrence.
AB - We describe a comprehensive, multidisciplinary treatment approach for lumbar vertebral hemangiomas (VHs) with spinal stenosis and radiculopathy. A 59-year-old female presented with 1 year of pain predominantly in the lower back, with pain in the left buttock and proximal left anterior thigh as well and magnetic resonance imaging of the lumbar spine demonstrated lumbar scoliosis and an L3 vertebral lesion suspicious for hemangioma. A computed tomography guided biopsy was done, which supported the diagnosis. Definitive treatment entailed preoperative angiography and embolization, followed by L3 laminectomy, right L3 pedicle resection, partial L3 corpectomy, L3 vertebral cement augmentation, and L1 to L5 instrumented fusion. By 1-year postoperatively, the patient reported no radicular pain and only mild groin pain attributed to left hip degenerative joint disease. Radiographs 1-year postoperatively confirmed the stability of the instrumented posterior fusion and a magnetic resonance imaging with and without contrast confirmed no VH recurrence. A comprehensive and multidisciplinary approach for the treatment of VHs with neurological symptoms or signs is presented. This approach is recommended to maximize lesion removal, ensure biomechanical stability, and minimize recurrence.
KW - Lumbar spine
KW - neoplasm
KW - vertebral hemangioma
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U2 - 10.4103/jcvjs.JCVJS_106_19
DO - 10.4103/jcvjs.JCVJS_106_19
M3 - Review article
C2 - 32089622
AN - SCOPUS:85078909723
SN - 0974-8237
VL - 10
SP - 259
EP - 262
JO - Journal of Craniovertebral Junction and Spine
JF - Journal of Craniovertebral Junction and Spine
IS - 4
ER -