Surgical treatment of aggressive hemangiomas of the transitional cervical-thoracic spine in children (сlinical observations, preliminary results)
- Authors: Zaretskov V.V.1, Arsenievich V.B.1, Likhachev S.V.1, Stepukhovich S.V.1, Mizyurov S.A.1
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Affiliations:
- Saratov State Medical University named after V.I. Razumovsky
- Issue: Vol 7, No 2 (2019)
- Pages: 79-86
- Section: Clinical cases
- URL: https://journals.rcsi.science/turner/article/view/11262
- DOI: https://doi.org/10.17816/PTORS7279-86
- ID: 11262
Cite item
Abstract
Introduction. Vertebral hemangioma is a common pathology, in which 3.7% cases are aggressive. One of the pathogenetic factors contributing to the growth of vertebral hemangioma is mechanical overload. The transitional parts of the spine are the most loaded. Lesions of the transitional cervical-thoracic spine by hemangioma are rare (2%–4% of all vertebral hemangiomas). A common treatment for aggressive hemangiomas is puncture vertebroplasty. Currently, the number of pediatric patients with vertebral hemangiomas has increased, with an incidence close to 8% for individuals aged below 18 years. Exaggeration of the possibilities of conservative treatment for hemangiomas in children often leads to unsatisfactory results. Clinical research on this problem is relevant due to the lack information about the surgical tactics in aggressive spinal hemangiomas in children.
Clinical observation. Two patients aged 15 and 17 years old with aggressive hemangiomas of the transitional cervical-thoracic spine underwent operation with the use of open-puncture vertebroplasty. There were no postoperative complications, and good preliminary results were obtained.
Discussion. Various approaches in the treatment of aggressive hemangiomas of the transitional cervical-thoracic spine in children, including open-puncture vertebroplasty, were presented and analyzed.
Conclusion. Due to the limited information about surgical treatment for pediatric vertebral hemangiomas, the presented clinical cases of surgical treatment for aggressive hemangiomas of the transitional cervical-thoracic spine may be of interest to a wide audience.
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##article.viewOnOriginalSite##About the authors
Vladimir V. Zaretskov
Saratov State Medical University named after V.I. Razumovsky
Author for correspondence.
Email: vvzaretskov@mail.ru
ORCID iD: 0000-0001-5921-2786
MD, PhD, D.Sc., Leading Research Assistant of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; Professor of the Department of Traumatology and Orthopedics
Russian Federation, 112, Bolshaya Kazachia street, 410012Vladislav B. Arsenievich
Saratov State Medical University named after V.I. Razumovsky
Email: vbarsenievich@mail.ru
ORCID iD: 0000-0003-4808-1578
MD, PhD, Head of the Third Traumatology and Orthopedics Department of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery
Russian Federation, 112, Bolshaya Kazachia street, 410012Sergey V. Likhachev
Saratov State Medical University named after V.I. Razumovsky
Email: Likha4@mail.ru
ORCID iD: 0000-0003-1874-2507
MD, PhD, Senior Research Assistant of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery
Russian Federation, 112, Bolshaya Kazachia street, 410012Sergey V. Stepukhovich
Saratov State Medical University named after V.I. Razumovsky
Email: Stepuh@yandex.ru
ORCID iD: 0000-0002-2194-1446
MD, PhD, Orthopedic and Trauma Surgeon of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery
Russian Federation, 112, Bolshaya Kazachia street, 410012Sergey A. Mizyurov
Saratov State Medical University named after V.I. Razumovsky
Email: miziurov@inbox.ru
ORCID iD: 0000-0002-8935-3384
MD, Orthopedic and Trauma Surgeon of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery; Post-Graduate Student of Traumatology and Orthopedics Department
Russian Federation, 112, Bolshaya Kazachia street, 410012References
- Мусаев Э.Р. Первичные опухоли позвоночника: обзор литературы // Практическая онкология. – 2010. – Т. 11. – № 1. – С. 19–24. [Musaev ER. Pervichnye opukholi pozvonochnika: obzor literatury. Prakticheskaia onkologiia. 2010;11(1):19-24. (In Russ.)]
- Kato S, Kawahara N, Murakami H, et al. Surgical management of aggressive vertebral hemangiomas causing spinal cord compression: long-term clinical follow-up of five cases. J Orthop Sci. 2010;15(3):350-356. https://doi.org/10.1007/s00776-010-1483-z.
- Кравцов М.Н., Мануковский В.А., Манащук В.И., и др. Диагностика и лечение агрессивных гемангиом позвонков. Клинические рекомендации. – М., 2015. [Kravtsov MN, Manukovskiĭ VA, Manashchuk VI, et al. Diagnosis and treatment of aggressive vertebral hemangiomas. Clinical guidelines. Moscow; 2015. (In Russ.)]
- Воронович И.Р., Пашкевич Л.А., Мартынюк С.Н. Гемангиома позвоночника // Медицинские новости. – 2014. – № 1. – С. 39–42. [Voronovich IR, Pashkevich LA, Martynyuk SN. Hemangioma of the spine. Meditsinskie novosti. 2014;(1):39-42. (In Russ.)]
- Шавладзе З.Н., Смирнов В.В., Елисеев Н.П., и др. Лучевая диагностика первичных опухолей позвоночника // Мануальная терапия. – 2010. – № 3. – С. 83–91. [Shavladze ZN, Smirnov VV, Eliseev NP, et al. Luchevaya diagnostika pervichnykh opukholey pozvonochnika. Manual’naia terapiia. 2010;(3):83-91. (In Russ.)]
- Зарецков В.В., Лихачев С.В., Арсениевич В.Б., и др. Гемангиомы позвоночника. Особенности диагностики и хирургического лечения // Успехи современного естествознания. – 2015. – № 6. – С. 22–27. [Zaretskov VV, Likhachev SV, Arsenievich VB, et al. Vertebral hemangiomas: Diagnostics and surgical treatment. Advances in current natural sciences. 2015;(6):22-27. (In Russ.)]
- Рерих В.В., Рахматиллаев Ш.Н., Пендюрин И.В. Результаты хирургического лечения пациентов с гемангиомами грудных и поясничных позвонков (опыт Новосибирского НИИТО) // Международный журнал прикладных и фундаментальных исследований. – 2015. – № 11-1. – С. 55–59. [Rerikh VV, Rakhmatillaev ShN, Pendyurin IV. Results of surgical treatment of patients with hemangiomas of the thoracic and lumbar spine (experience of the novosibirsk NRITO). Mezhdunarodnyy zhurnal prikladnykh i fundamental’nykh issledovaniy. 2015;(11-1):55-59. (In Russ.)]
- Jiang L, Liu XG, Yuan HS, et al. Diagnosis and treatment of vertebral hemangiomas with neurologic deficit: a report of 29 cases and literature review. Spine J. 2014;14(6):944-954. https://doi.org/10.1016/j.spinee.2013.07.450.
- Urrutia J, Postigo R, Larrondo R, Martin AS. Clinical and imaging findings in patients with aggressive spinal hemangioma requiring surgical treatment. J Clin Neurosci. 2011;18(2):209-212. https://doi.org/10.1016/j.jocn.2010.05.022.
- Issa M, Lucas G, Violas P, et al. Vertebroplasty for vertebral hemangioma in children: a report of two cases with 2-year follow-up. Childs Nerv Syst. 2015;31(11):2179-2183. https://doi.org/10.1007/s00381-015-2777-4.
- Cheung NK, Doorenbosch X, Christie JG. Rapid onset aggressive vertebral haemangioma. Childs Nerv Syst. 2011;27(3):469-472. https://doi.org/10.1007/s00381-011-1391-3.
- Gajaseni P, Labianca L, Lacerda I, Weinstein S. A child with a rare extraosseous extension and pathologic fracture from a vertebral hemangioma: a case report. JBJS Case Connect. 2017;7(4):e86. https://doi.org/10.2106/JBJS.CC.17.00057.
- Jha B, Choudhary AK. Unusual cause of back pain in an adolescent patient: a case report and natural history of aggressive vertebral hemangioma in children. Pain Physician. 2008;11(5):687-692.
- Танкачеев Р.Ш. Метод пункционной вертебропластики в лечении агрессивных гемангиом труднодоступной локализации верхнегрудных позвонков // Нейрохирургия и неврология Казахстана. – 2012. – № 1. – С. 21–25. [Tankacheev RS. Metod punktsionnoy vertebroplastiki v lechenii agressivnykh gemangiom trudnodostupnoy lokalizatsii verkhnegrudnykh pozvonkov. Neirokhirurgiia i nevrologiia Kazakhstana. 2012;1(26):21-25. (In Russ.)]
- Bao L, Jia P, Li J, et al. Percutaneous vertebroplasty relieves pain in cervical spine metastases. Pain Res Manag. 2017;2017:3926318. https://doi.org/10.1155/2017/3926318.
- Duprez T, Lokietek W, Clapuyt P, et al. Multiple aggressive vertebral haemangiomas in an adolescent: a case report. Pediatr Radiol. 1998;28(1):51-53. https://doi.org/10.1007/s002470050291.
- Cherian J, Sayama CM, Adesina AM, et al. Multilevel thoracic hemangioma with spinal cord compression in a pediatric patient: case report and review of the literature. Childs Nerv Syst. 2014;30(9):1571-1576. https://doi.org/10.1007/s00381-014-2441-4.
- Bassou D, Benaissa AD, El Khyari A, et al. Vertebral hemangioma: a rare cause of cord compression in children. J Radiol. 2008;89(2):262-263. https://doi.org/10.1016/S0221-0363(08)70404-9.
- Курамшин А.Ф., Сафин Ш.М., Нагаев Р.Я., и др. Особенности проведения вертебропластики при гемангиомах шейного отдела позвоночника // Хирургия позвоночника. – 2015. – Т. 12. – № 4. – С. 80–83. [Kuramshin AF, Safin ShM, Nagaev RY, et al. Vertebroplasty for cervical spine hemangioma. Spine surgery. 2015;12(4):80-83. (In Russ.)]
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