A novel surgical technique for aggressive vertebral hemangiomas

Area of Science:

• Neurosurgery
• Oncology
• Orthopedics

Background:

• Vertebral hemangiomas are common vascular malformations, but aggressive subtypes causing spinal cord compression are rare and pose significant surgical challenges.
• Spinal cord compression from vertebral hemangiomas can lead to severe neurological deficits, necessitating effective treatment strategies.

Observation:

• A 19-year-old male presented with thoracic back pain due to an aggressive vertebral hemangioma at T11.
• Radiological imaging revealed vertebral bone destruction and epidural soft tissue extension of the hemangioma.
• The patient had normal neurological examination findings despite the aggressive nature of the lesion.

Findings:

• A novel surgical technique combining radiofrequency ablation, FLOSEAL hemostatic agent, and autologous bone grafting was successfully employed.
• This minimally invasive approach achieved excellent hemostasis and structural reinforcement of the affected T11 vertebral body.
• The patient experienced complete resolution of back pain postoperatively with no intra- or post-surgical complications.

Implications:

• This innovative surgical strategy offers improved bleeding control and vertebral body reconstruction for aggressive vertebral hemangiomas.
• The technique holds promise for managing challenging spinal vascular lesions, potentially reducing surgical risks and improving patient outcomes.
• Further research may validate this approach for a wider range of spinal tumors and vascular malformations.