M.N. Kravcov, V.A. Manukovskiy, A.V. Fedorenkov
Medicomilitary Academy, Saint Petersburg, Russia
There are two known groups of vertebral hemangiomas. The first one (more than 90%) is represented by peculiar telangiectases in an atrophied porous senile spongy bone, increasing proportionally to age and having no clinical significance. The second group consists of tumors proper, spreading along the whole vertebra and outside it and causing compression of neural structures (0.9-4%). Tactics of treatment, concerning this clinical entity, is still unclear.
The study goal has been estimating efficacy of puncture vertebroplasty (PVP) and radiotherapy (RT), used for treatment of aggressive vertebral hemangiomas.
Material and Methods. Examination data and results of treatment of 101 cases (100%; 147 vertebrae) were analyzed. There were 26 males (25.7%; 35 vertebrae) and 75 females (74.3%; 112 vertebrae). Mean age was 52.7 years. The main group included 43 cases ( 42.6%; 53 vertebrae), treated surgically. The control group consisted of 58 cases (57.4%; 94 vertebrae), subjected to radiotherapy.
Results and Conclusion. PVP was a more effective method of treatment in comparison with RT. It promoted reduction of pain syndrome severity by 34.4-77.8% from the initial level in 76.7% of cases, whereas RT resulted in regression of local pain by 12.9-28.1% in 43.1% of cases. Thus, PVP is a little-invasive method, characterized by a minimum rate of complications and considerable shortening of a period of stay in hospital. Exceeding a threshold score (5 and more), obtained on the basis of the proposed scale of hemangioma aggressiveness, is an indication for PVP.