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. 2014 Mar;48(2):163-7.
doi: 10.4103/0019-5413.128759.

Percutaneous vertebroplasty in painful refractory vertebral hemangiomas

Rv Narayana  1 , Rajesh Pati  1 , Sibasankar Dalai  2
Affiliations

Percutaneous vertebroplasty in painful refractory vertebral hemangiomas

Rv Narayana et al. Indian J Orthop. 2014 Mar.

Abstract

Background: Painful vertebral hemangiomas are often inadequately managed medically. We evaluated the outcome of percutaneous vertebroplasty (PVP) in the treatment of painful vertebral hemangiomas refractory to medical management.

Materials and methods: 14 patients (four thoracic and ten lumbar vertebra) with painful vertebral hemangiomas presenting with severe back pain for more than 6 months not responding to medical therapy were treated by vertebroplasty. Cross sectional imaging of the spine with magnetic resonance was done. Blood investigations were done to exclude coagulopathy excluded. PVP was performed under local anesthesia.

Results: The pain intensity numeric rating scale (PI-NRS-11) of these patients was in the range of 7-10 (Severe Pain). After vertebroplasty 8 patients were completely free of pain (PI NRS Score 0) while 6 were significantly relieved (PI-NRS Score 1-3). No complications were observed. Two patients with associated radicular pain had good pain relief following PVP. No recurrence was found during 36 months of postoperative followup.

Conclusion: PVP is a safe and effective procedure in patients with painful vertebral hemangiomas refractory to medical management.

Keywords: Hemangioma; percutaneous vertebroplasty; polymethyl methacrylate.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
(a) Magnetic resonance imaging T2W sagital view showing L4 vertebral hemangioma (b) Needle position under fluoroscopy (antero-posterior and lateral view), (c) Lateral view fluoroscopy after vertebroplasty demonstrating good cement filling
Figure 2
Figure 2
(a) Fluoroscopic view (lateral) showing vertebral hemangioma with trabeculations. (b) Needle position. (c) Radiograph post vertebroplasty
Figure 3
Figure 3
(a) Magnetic resonance imaging T2W sagittal view showing L3 vertebral hemangioma and osteoporotic compression fracture of D12, (b) Fluoroscop ic view demonstrating needle position, (c) Vertebroplasty of L3 hemangioma and osteoporotic D12 vertebra
See this image and copyright information in PMC

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